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Resource Profile: PluginPatient - Detailed Descriptions

Draft as of 2025-01-16

Definitions for the plugin-patient resource profile.

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

0. Patient
Definition

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

ShortPatientInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Alternate NamesSubjectOfCare Client Resident, Patient, nl-core-Patient
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
2. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The nationality of the patient.

ShortNationality
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.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Patient Nationality) (Complex Extension)
Standard StatusNormative (from Normative)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Patient.extension:nationality.extension:code
Slice Namecode
Definition

Code representing nationality of patient.

ShortNationality CodeAdditional content defined by implementations
Comments

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

Control0..1*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifierfalse
Standard StatusNormative (from Normative)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Patient.extension:nationality.extension:code.extension
Definition

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

ShortAdditional content defined by implementations
Comments

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

Control0..0*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifierfalse
Standard StatusNormative (from Normative)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis 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.

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuecode
    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).

    ShortNationalityValue of extension
    Control10..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see NationaliteitCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20200901000000)
    TypeCodeableConcept, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Standard StatusNormative (from Normative)
    Alternate NamesNationaliteit
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Patient.extension:nationality.extension:period
    Slice Nameperiod
    Definition

    Period when nationality was effective.

    ShortNationality PeriodAdditional content defined by implementations
    Comments

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

    Control0..1*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifierfalse
    Standard StatusNormative (from Normative)
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Patient.extension:nationality.extension:period.extension
    Definition

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

    ShortAdditional content defined by implementations
    Comments

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

    Control0..0*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifierfalse
    Standard StatusNormative (from Normative)
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis 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.

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valueperiod
      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).

      ShortValue of extension
      Control10..1
      This element is affected by the following invariants: ele-1
      TypePeriod, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Patient.extension:nationality.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttp://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).

      ShortValue of extension
      Control0..01
      This element is affected by the following invariants: ele-1
      TypeChoice 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 Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      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).

      ShortExtensions that cannot be ignored
      Comments

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

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Standard StatusNormative (from Normative)
      Requirements

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

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

        ShortPatientIdentificationNumberAn identifier for this patient
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..*
        This element is affected by the following invariants: ele-1
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Patients are almost always assigned specific numerical identifiers.

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

          An identifier for this patient.

          ShortAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Is Modifierfalse
          Standard StatusNormative (from Normative)
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

          Pattern Value{
            "system" : "http://fhir.nl/fhir/NamingSystem/bsn"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Patient.identifier:patientnummer
          Slice Namepatientnummer
          Definition

          Patientnummer zoals gebruikt in het EPD


          An identifier for this patient.

          ShortPatientnummer zoals gebruikt in het EPDAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control10..1*
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

          Alternate NamesIdentificatienummer
          Pattern Value{
            "type" : {
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "MR"
              }]
            }
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Patient.identifier:patientnummer.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Patient.identifier:patientnummer.type
          Definition

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

          Control10..1
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

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

          Patientnummer


          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortPatientnummerThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Patient.active
          Definition

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

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

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

          ShortWhether this patient's record is in active use
          Comments

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

          Control0..1
          This element is affected by the following invariants: ele-1
          Typeboolean
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          Patient's full name.


          A name associated with the individual.

          ShortNameInformation / 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.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeHumanName
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

          Alternate NamesNaamgegevens, BetalerNaam
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ use
          • 44. Patient.name:nameInformation
            Slice NamenameInformation
            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.

            ShortNameInformationA 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.

            Control0..2*
            This element is affected by the following invariants: ele-1
            TypeHumanName(nl core NameInformation)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Alternate NamesNaamgegevens, nl-core-NameInformation
            Invariantsele-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())
            46. Patient.name:nameInformation.extension:nameUsage
            Slice NamenameUsage
            Definition

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

            ShortPreferred display order of name parts
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Assembly Order) (Extension Type: code)
            Standard StatusNormative (from Normative)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            48. Patient.name:nameInformation.extension:nameUsage.extension
            Definition

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

            ShortAdditional content defined by implementations
            Comments

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

            Control0..0*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifierfalse
            Standard StatusNormative (from Normative)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis 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
            • 50. Patient.name:nameInformation.extension:nameUsage.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

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

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-assembly-order
              52. 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).

              ShortNameUsageValue of extension
              Control10..1
              This element is affected by the following invariants: ele-1
              BindingThe 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.

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

              Identifies the purpose for this name.

              Shortusual | official | temp | nickname | anonymous | old | maiden
              Comments

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

              Control10..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
              (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

              The use of a human name.

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

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

              Pattern Valueofficial
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Patient.name:nameInformation.text
              Definition

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

              ShortText representation of the full name
              Comments

              A representation of the full name, including given names and the family name.

              When implementing zib NameInformation, this representation should include the FirstNames or Initials and the family name constructed according to the NameUsage concept.


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

              Control0..1
              This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              A renderable, unencoded form.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. 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.

              ShortFamily 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).

              Control0..1
              This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate Namessurname
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              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())
              60. Patient.name:nameInformation.family.extension:prefix
              Slice Nameprefix
              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.

              ShortVoorvoegsel 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.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Own Prefix) (Extension Type: string)
              Standard StatusNormative (from Normative)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              62. Patient.name:nameInformation.family.extension:prefix.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

              Control0..0*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Is Modifierfalse
              Standard StatusNormative (from Normative)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis 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
              • 64. Patient.name:nameInformation.family.extension:prefix.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-prefix
                66. 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).

                ShortPrefixValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Normative)
                Alternate NamesVoorvoegsels
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. Patient.name:nameInformation.family.extension:lastName
                Slice NamelastName
                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.

                ShortPortion 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".

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Own Name) (Extension Type: string)
                Standard StatusNormative (from Normative)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                70. Patient.name:nameInformation.family.extension:lastName.extension
                Definition

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

                ShortAdditional content defined by implementations
                Comments

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

                Control0..0*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Is Modifierfalse
                Standard StatusNormative (from Normative)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis 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
                • 72. Patient.name:nameInformation.family.extension:lastName.url
                  Definition

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

                  Shortidentifies the meaning of the extension
                  Comments

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

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-name
                  74. 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).

                  ShortLastNameValue of extension
                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Standard StatusNormative (from Normative)
                  Alternate NamesAchternaam
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. Patient.name:nameInformation.family.extension:partnerPrefix
                  Slice NamepartnerPrefix
                  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.

                  ShortVoorvoegsel 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.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Partner Prefix) (Extension Type: string)
                  Standard StatusNormative (from Normative)
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  78. Patient.name:nameInformation.family.extension:partnerPrefix.extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

                  Control0..0*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Is Modifierfalse
                  Standard StatusNormative (from Normative)
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis 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
                  • 80. Patient.name:nameInformation.family.extension:partnerPrefix.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
                    82. 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).

                    ShortPartnerPrefixValue of extension
                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Standard StatusNormative (from Normative)
                    Alternate NamesVoorvoegselsPartner
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. Patient.name:nameInformation.family.extension:partnerLastName
                    Slice NamepartnerLastName
                    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.

                    ShortPortion derived from person's partner's 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".

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Partner Name) (Extension Type: string)
                    Standard StatusNormative (from Normative)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    86. Patient.name:nameInformation.family.extension:partnerLastName.extension
                    Definition

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

                    ShortAdditional content defined by implementations
                    Comments

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

                    Control0..0*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifierfalse
                    Standard StatusNormative (from Normative)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis 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
                    • 88. Patient.name:nameInformation.family.extension:partnerLastName.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      Comments

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

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-name
                      90. 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).

                      ShortPartnerLastNameValue of extension
                      Control10..1
                      This element is affected by the following invariants: ele-1
                      Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Normative)
                      Alternate NamesAchternaamPartner
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      92. 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.

                      ShortFirstName / 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.

                      Control0..*
                      This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate Namesfirst name, middle name, Voornaam, Initiaal
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      94. Patient.name:nameInformation.given.extension
                      Definition

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

                      ShortAdditional content defined by implementations
                      Comments

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

                      Control10..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis 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
                      • 96. Patient.name:nameInformation.given.extension:givenOrInitial
                        Slice NamegivenOrInitial
                        Definition

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

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

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

                        Control1..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension(EN Qualifier) (Extension Type: code)
                        Is Modifierfalse
                        Standard StatusNormative (from Normative)
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        98. Patient.name:nameInformation-GivenName
                        Slice NamenameInformation-GivenName
                        Definition

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


                        A name associated with the individual.

                        ShortName 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.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeHumanName(nl core NameInformation.GivenName)
                        Is Modifierfalse
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Requirements

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

                        Alternate Namesnl-core-NameInformation.GivenName
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. 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.

                        ShortContactInformationA 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).

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeContactPoint
                        Is Modifierfalse
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Requirements

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

                        Alternate NamesContactgegevens
                        Invariantsele-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())
                        SlicingThis element introduces a set of slices on Patient.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • profile @ $this
                        • 102. Patient.telecom:telephoneNumbers
                          Slice NametelephoneNumbers
                          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.

                          ShortTelephoneNumbersA 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.


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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeContactPoint(nl core ContactInformation TelephoneNumbers)
                          Is Modifierfalse
                          Standard StatusNormative (from Normative)
                          Summarytrue
                          Requirements

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

                          Alternate NamesTelefoonnummers, nl-core-ContactInformation-TelephoneNumbers
                          Invariantsele-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())
                          104. Patient.telecom:emailAddresses
                          Slice NameemailAddresses
                          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.

                          ShortEmailAddressesA contact detail for the individual
                          Comments

                          Implementation of the "EmailAddresses" concept of zib ContactInformation.


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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeContactPoint(nl core ContactInformation EmailAddresses)
                          Is Modifierfalse
                          Standard StatusNormative (from Normative)
                          Summarytrue
                          Requirements

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

                          Alternate NamesEmailAdressen, nl-core-ContactInformation-EmailAddresses
                          Invariantsele-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())
                          106. Patient.gender
                          Definition

                          Patient’s administrative gender.


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

                          ShortGendermale | 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.

                          Control10..1
                          This element is affected by the following invariants: ele-1
                          BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                          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.

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

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

                          Alternate NamesGeslacht
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. Patient.gender.extension:genderCodelist
                          Slice NamegenderCodelist
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          Comments

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

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ext CodeSpecification) (Extension Type: CodeableConcept)
                          Standard StatusNormative (from Normative)
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          110. Patient.gender.extension:genderCodelist.url
                          Definition

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

                          Shortidentifies the meaning of the extension
                          Comments

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

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification
                          112. 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.

                          ShortDateOfBirthThe date of birth for the individual
                          Comments

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

                          Control10..1
                          This element is affected by the following invariants: ele-1
                          Typedate
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Age of the individual drives many clinical processes.

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

                          Indicates if the individual is deceased or not.

                          ShortIndicates if the individual is deceased or not
                          Comments

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

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

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 116. Patient.deceased[x]:deceasedBoolean
                            Slice NamedeceasedBoolean
                            Definition

                            An indication stating whether the patient has died.


                            Indicates if the individual is deceased or not.

                            ShortDeathIndicatorIndicates if the individual is deceased or not
                            Comments

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

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

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

                            Alternate NamesOverlijdensIndicator
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. Patient.deceased[x]:deceasedDateTime
                            Slice NamedeceasedDateTime
                            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.

                            ShortDateOfDeathIndicates 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.


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

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

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

                            Alternate NamesDatumOverlijden, OverlijdensIndicator
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. 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.

                            ShortAddressInformationAn 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 HP home both
                            Visit Address/Woon-/verblijfadres PHYS home physical
                            Temporary Address/Tijdelijk adres TMP temp
                            Work Place/Werkadres WP work
                            Vacation Home/Vakantie adres HV 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.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeAddress(nl core AddressInformation)
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Alternate NamesAdresgegevens, nl-core-AddressInformation
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. Patient.address.extension:addressType
                            Slice NameaddressType
                            Definition

                            Optional Extension Element - found in all resources.

                            ShortOptional Extensions Element
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ext AddressInformation.AddressType) (Extension Type: CodeableConcept)
                            Standard StatusNormative (from Normative)
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            124. Patient.address.use
                            Definition

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


                            The purpose of this address.

                            ShortAddressTypehome | 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.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingThe 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.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

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

                            Alternate NamesAdresSoort
                            Example<br/><b>General</b>:home
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. 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.

                            ShortPostcodePostal code for area
                            Comments

                            Note that FHIR strings SHALL NOT exceed 1MB in size

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Alternate NamesZip, Postcode
                            Example<br/><b>General</b>:9132
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. Patient.multipleBirth[x]
                            Definition

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

                            ShortWhether patient is part of a multiple birth
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeChoice of: boolean, integer
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Standard StatusNormative (from Normative)
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis 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
                            • 130. Patient.multipleBirth[x]:multipleBirthBoolean
                              Slice NamemultipleBirthBoolean
                              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).

                              ShortMultipleBirthIndicatorWhether patient is part of a multiple birth
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typeboolean, integer
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Standard StatusNormative (from Normative)
                              Requirements

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

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

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

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

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

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeBackboneElement
                              Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                              Summarytrue
                              Requirements

                              There are multiple use cases:

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

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

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

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

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

                              The other patient resource that the link refers to.

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

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

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeReference(Patient, RelatedPerson)
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                              138. Patient.link.type
                              Definition

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

                              Shortreplaced-by | replaces | refer | seealso
                              Comments

                              Note that FHIR strings SHALL NOT exceed 1MB in size

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                              (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

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

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

                              0. Patient
                              2. Patient.identifier
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control1..?
                              Must Supporttrue
                              4. Patient.identifier:patientnummer
                              Slice Namepatientnummer
                              Definition

                              Patientnummer zoals gebruikt in het EPD

                              ShortPatientnummer zoals gebruikt in het EPD
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control1..1
                              Must Supporttrue
                              Pattern Value{
                                "type" : {
                                  "coding" : [{
                                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code" : "MR"
                                  }]
                                }
                              }
                              6. Patient.identifier:patientnummer.type
                              Control1..?
                              8. Patient.identifier:patientnummer.value
                              Definition

                              Patientnummer

                              ShortPatientnummer
                              Control1..?
                              10. Patient.name
                              Must Supporttrue
                              12. Patient.name:nameInformation
                              Slice NamenameInformation
                              Must Supporttrue
                              14. Patient.name:nameInformation.family
                              Must Supporttrue
                              16. Patient.gender
                              Control1..?
                              Must Supporttrue
                              18. Patient.birthDate
                              Control1..?
                              Must Supporttrue
                              20. Patient.deceased[x]
                              TypedateTime, boolean
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              22. Patient.address
                              24. Patient.address.use
                              Must Supporttrue
                              26. Patient.address.postalCode
                              Must Supporttrue

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

                              0. Patient
                              Definition

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

                              ShortPatient
                              Control0..*
                              Alternate NamesSubjectOfCare Client Resident, Patient, nl-core-Patient
                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                              dom-6: A resource should have narrative for robust management (text.`div`.exists())
                              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                              2. Patient.id
                              Definition

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

                              ShortLogical id of this artifact
                              Comments

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

                              Control0..1
                              Typeid
                              Summarytrue
                              4. Patient.meta
                              Definition

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

                              ShortMetadata about the resource
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeMeta
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              6. Patient.implicitRules
                              Definition

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

                              ShortA set of rules under which this content was created
                              Comments

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

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

                              The base language in which the resource is written.

                              ShortLanguage of the resource content
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHOULD be taken from CommonLanguages
                              (preferred to http://hl7.org/fhir/ValueSet/languages)

                              A human language.

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

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

                              ShortText summary of the resource, for human interpretation
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeNarrative
                              Alternate Namesnarrative, html, xhtml, display
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              12. Patient.contained
                              Definition

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

                              ShortContained, inline Resources
                              Comments

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

                              Control0..*
                              TypeResource
                              Alternate Namesinline resources, anonymous resources, contained resources
                              14. Patient.extension
                              Definition

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

                              ShortAdditional content defined by implementations
                              Comments

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

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standard StatusNormative (from Normative)
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 16. Patient.extension:nationality
                                Slice Namenationality
                                Definition

                                The nationality of the patient.

                                ShortNationality
                                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.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Patient Nationality) (Complex Extension)
                                Standard StatusNormative (from Normative)
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                18. Patient.extension:nationality.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                XML FormatIn the XML format, this property is represented as an attribute.
                                20. Patient.extension:nationality.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Standard StatusNormative (from Normative)
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 22. Patient.extension:nationality.extension:code
                                  Slice Namecode
                                  Definition

                                  Code representing nationality of patient.

                                  ShortNationality Code
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Normative)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  24. Patient.extension:nationality.extension:code.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  26. Patient.extension:nationality.extension:code.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

                                  Control0..0
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Normative)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 28. Patient.extension:nationality.extension:code.url
                                    Definition

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

                                    Shortidentifies the meaning of the extension
                                    Comments

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

                                    Control1..1
                                    Typeuri
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Fixed Valuecode
                                    30. Patient.extension:nationality.extension:code.value[x]
                                    Definition

                                    Indicates the country of citizenship.

                                    ShortNationality
                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    BindingUnless not suitable, these codes SHALL be taken from NationaliteitCodelijst
                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20200901000000)
                                    TypeCodeableConcept
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Standard StatusNormative (from Normative)
                                    Alternate NamesNationaliteit
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    32. Patient.extension:nationality.extension:period
                                    Slice Nameperiod
                                    Definition

                                    Period when nationality was effective.

                                    ShortNationality Period
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Normative)
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    34. Patient.extension:nationality.extension:period.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    36. Patient.extension:nationality.extension:period.extension
                                    Definition

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

                                    Control0..0
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Normative)
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 38. Patient.extension:nationality.extension:period.url
                                      Definition

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

                                      Shortidentifies the meaning of the extension
                                      Comments

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

                                      Control1..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed Valueperiod
                                      40. 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).

                                      ShortValue of extension
                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      TypePeriod
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Standard StatusNormative (from Normative)
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      42. Patient.extension:nationality.url
                                      Definition

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

                                      Shortidentifies the meaning of the extension
                                      Comments

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

                                      Control1..1
                                      Typeuri
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-nationality
                                      44. 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).

                                      ShortValue of extension
                                      Control0..0
                                      This element is affected by the following invariants: ele-1
                                      TypeChoice 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
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Standard StatusNormative (from Normative)
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      46. Patient.modifierExtension
                                      Definition

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

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

                                      ShortExtensions that cannot be ignored
                                      Comments

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

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                      Standard StatusNormative (from Normative)
                                      Requirements

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

                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Patient.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 48. 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.

                                        ShortPatientIdentificationNumber
                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control1..*
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Patients are almost always assigned specific numerical identifiers.

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

                                          An identifier for this patient.

                                          ShortAn identifier for this patient
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeIdentifier
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Requirements

                                          Patients are almost always assigned specific numerical identifiers.

                                          Pattern Value{
                                            "system" : "http://fhir.nl/fhir/NamingSystem/bsn"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          52. Patient.identifier:patientnummer
                                          Slice Namepatientnummer
                                          Definition

                                          Patientnummer zoals gebruikt in het EPD

                                          ShortPatientnummer zoals gebruikt in het EPD
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          TypeIdentifier
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Patients are almost always assigned specific numerical identifiers.

                                          Alternate NamesIdentificatienummer
                                          Pattern Value{
                                            "type" : {
                                              "coding" : [{
                                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                                "code" : "MR"
                                              }]
                                            }
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          54. Patient.identifier:patientnummer.id
                                          Definition

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

                                            The purpose of this identifier.

                                            Shortusual | official | temp | secondary | old (If known)
                                            Comments

                                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                            Control0..1
                                            BindingThe codes SHALL be taken from IdentifierUse
                                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                            Identifies the purpose for this identifier, if known .

                                            Typecode
                                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            60. Patient.identifier:patientnummer.type
                                            Definition

                                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                            ShortDescription of identifier
                                            Comments

                                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                            Control1..1
                                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Allows users to make use of identifiers when the identifier system is not known.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            62. Patient.identifier:patientnummer.system
                                            Definition

                                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                            ShortThe namespace for the identifier value
                                            Comments

                                            Identifier.system is always case sensitive.

                                            Control0..1
                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            64. Patient.identifier:patientnummer.value
                                            Definition

                                            Patientnummer

                                            ShortPatientnummer
                                            Comments

                                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                            Control1..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Example<br/><b>General</b>:123456
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            66. Patient.identifier:patientnummer.period
                                            Definition

                                            Time period during which identifier is/was valid for use.

                                            ShortTime period when id is/was valid for use
                                            Control0..1
                                            TypePeriod
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            68. Patient.identifier:patientnummer.assigner
                                            Definition

                                            Organization that issued/manages the identifier.

                                            ShortOrganization that issued id (may be just text)
                                            Comments

                                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                            Control0..1
                                            TypeReference(Organization)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            70. Patient.active
                                            Definition

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

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

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

                                            ShortWhether this patient's record is in active use
                                            Comments

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

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typeboolean
                                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

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

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

                                            Patient's full name.

                                            ShortNameInformation / PayerName
                                            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.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeHumanName
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

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

                                            Alternate NamesNaamgegevens, BetalerNaam
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ use
                                            • 74. Patient.name:nameInformation
                                              Slice NamenameInformation
                                              Definition

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

                                              ShortNameInformation
                                              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.

                                              Control0..2
                                              This element is affected by the following invariants: ele-1
                                              TypeHumanName(nl core NameInformation)
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

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

                                              Alternate NamesNaamgegevens, nl-core-NameInformation
                                              Invariantsele-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())
                                              76. Patient.name:nameInformation.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              78. Patient.name:nameInformation.extension
                                              Definition

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Standard StatusNormative (from Normative)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 80. Patient.name:nameInformation.extension:nameUsage
                                                Slice NamenameUsage
                                                Definition

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

                                                ShortPreferred display order of name parts
                                                Comments

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

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(Assembly Order) (Extension Type: code)
                                                Standard StatusNormative (from Normative)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                82. Patient.name:nameInformation.extension:nameUsage.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                84. Patient.name:nameInformation.extension:nameUsage.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

                                                Control0..0
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Normative)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 86. Patient.name:nameInformation.extension:nameUsage.url
                                                  Definition

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

                                                  Shortidentifies the meaning of the extension
                                                  Comments

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

                                                  Control1..1
                                                  Typeuri
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-assembly-order
                                                  88. 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.

                                                  ShortNameUsage
                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  BindingThe codes SHALL be taken from 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.

                                                  Typecode
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Standard StatusNormative (from Normative)
                                                  Alternate NamesNaamgebruik
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  90. Patient.name:nameInformation.use
                                                  Definition

                                                  Identifies the purpose for this name.

                                                  Shortusual | official | temp | nickname | anonymous | old | maiden
                                                  Comments

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

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  BindingThe codes SHALL be taken from NameUse
                                                  (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                                                  The use of a human name.

                                                  Typecode
                                                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

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

                                                  Pattern Valueofficial
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  92. Patient.name:nameInformation.text
                                                  Definition

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

                                                  ShortText representation of the full name
                                                  Comments

                                                  A representation of the full name, including given names and the family name.

                                                  When implementing zib NameInformation, this representation should include the FirstNames or Initials and the family name constructed according to the NameUsage concept.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  A renderable, unencoded form.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  94. 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.

                                                  ShortFamily 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.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Alternate Namessurname
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  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())
                                                  96. Patient.name:nameInformation.family.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  98. Patient.name:nameInformation.family.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Normative)
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Patient.name.family.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 100. Patient.name:nameInformation.family.extension:prefix
                                                    Slice Nameprefix
                                                    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.

                                                    ShortVoorvoegsel 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.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(Own Prefix) (Extension Type: string)
                                                    Standard StatusNormative (from Normative)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    102. Patient.name:nameInformation.family.extension:prefix.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    104. Patient.name:nameInformation.family.extension:prefix.extension
                                                    Definition

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Standard StatusNormative (from Normative)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 106. Patient.name:nameInformation.family.extension:prefix.url
                                                      Definition

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

                                                      Shortidentifies the meaning of the extension
                                                      Comments

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

                                                      Control1..1
                                                      Typeuri
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-prefix
                                                      108. Patient.name:nameInformation.family.extension:prefix.value[x]
                                                      Definition

                                                      Prefix to the person’s own last name.

                                                      ShortPrefix
                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Standard StatusNormative (from Normative)
                                                      Alternate NamesVoorvoegsels
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      110. Patient.name:nameInformation.family.extension:lastName
                                                      Slice NamelastName
                                                      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.

                                                      ShortPortion 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".

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(Own Name) (Extension Type: string)
                                                      Standard StatusNormative (from Normative)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      112. Patient.name:nameInformation.family.extension:lastName.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      114. Patient.name:nameInformation.family.extension:lastName.extension
                                                      Definition

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

                                                      Control0..0
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Normative)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 116. Patient.name:nameInformation.family.extension:lastName.url
                                                        Definition

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

                                                        Shortidentifies the meaning of the extension
                                                        Comments

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

                                                        Control1..1
                                                        Typeuri
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-name
                                                        118. Patient.name:nameInformation.family.extension:lastName.value[x]
                                                        Definition

                                                        The person’s official last name

                                                        ShortLastName
                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Standard StatusNormative (from Normative)
                                                        Alternate NamesAchternaam
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        120. Patient.name:nameInformation.family.extension:partnerPrefix
                                                        Slice NamepartnerPrefix
                                                        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.

                                                        ShortVoorvoegsel 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.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(Partner Prefix) (Extension Type: string)
                                                        Standard StatusNormative (from Normative)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        122. Patient.name:nameInformation.family.extension:partnerPrefix.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        124. Patient.name:nameInformation.family.extension:partnerPrefix.extension
                                                        Definition

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

                                                        ShortAdditional content defined by implementations
                                                        Comments

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

                                                        Control0..0
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Standard StatusNormative (from Normative)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 126. Patient.name:nameInformation.family.extension:partnerPrefix.url
                                                          Definition

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

                                                          Shortidentifies the meaning of the extension
                                                          Comments

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

                                                          Control1..1
                                                          Typeuri
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
                                                          128. Patient.name:nameInformation.family.extension:partnerPrefix.value[x]
                                                          Definition

                                                          Prefix to the partner’s last name.

                                                          ShortPartnerPrefix
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Standard StatusNormative (from Normative)
                                                          Alternate NamesVoorvoegselsPartner
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          130. Patient.name:nameInformation.family.extension:partnerLastName
                                                          Slice NamepartnerLastName
                                                          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.

                                                          ShortPortion derived from person's partner's 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".

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Partner Name) (Extension Type: string)
                                                          Standard StatusNormative (from Normative)
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          132. Patient.name:nameInformation.family.extension:partnerLastName.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          134. Patient.name:nameInformation.family.extension:partnerLastName.extension
                                                          Definition

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

                                                          Control0..0
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Standard StatusNormative (from Normative)
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 136. Patient.name:nameInformation.family.extension:partnerLastName.url
                                                            Definition

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

                                                            Shortidentifies the meaning of the extension
                                                            Comments

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

                                                            Control1..1
                                                            Typeuri
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-name
                                                            138. Patient.name:nameInformation.family.extension:partnerLastName.value[x]
                                                            Definition

                                                            Partner’s official last name.

                                                            ShortPartnerLastName
                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Standard StatusNormative (from Normative)
                                                            Alternate NamesAchternaamPartner
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            140. Patient.name:nameInformation.family.value
                                                            Definition

                                                            Primitive value for string

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

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

                                                            ShortFirstName / Initial
                                                            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.

                                                            Control0..*
                                                            This element is affected by the following invariants: ele-1, nl-core-NameInformation-01
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Alternate Namesfirst name, middle name, Voornaam, Initiaal
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            144. Patient.name:nameInformation.given.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            146. Patient.name:nameInformation.given.extension
                                                            Definition

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

                                                            ShortAdditional content defined by implementations
                                                            Comments

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

                                                            Control1..*
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Standard StatusNormative (from Normative)
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Patient.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 148. Patient.name:nameInformation.given.extension:givenOrInitial
                                                              Slice NamegivenOrInitial
                                                              Definition

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

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

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

                                                              Control1..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(EN Qualifier) (Extension Type: code)
                                                              Is Modifierfalse
                                                              Standard StatusNormative (from Normative)
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              150. Patient.name:nameInformation.given.value
                                                              Definition

                                                              Primitive value for string

                                                              ShortPrimitive value for string
                                                              Control0..1
                                                              Typestring
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Max Length:1048576
                                                              152. Patient.name:nameInformation.prefix
                                                              Definition

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

                                                              ShortTitles
                                                              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.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Alternate NamesTitels
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              154. Patient.name:nameInformation.suffix
                                                              Definition

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

                                                              ShortTitles
                                                              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.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Alternate NamesTitels
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              156. Patient.name:nameInformation.period
                                                              Definition

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

                                                              ShortTime period when name was/is in use
                                                              Comments

                                                              A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                              Period is not used for a duration (a measure of elapsed time). See Duration.

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypePeriod
                                                              Summarytrue
                                                              Requirements

                                                              Allows names to be placed in historical context.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                              158. Patient.name:nameInformation-GivenName
                                                              Slice NamenameInformation-GivenName
                                                              Definition

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

                                                              ShortName 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.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeHumanName(nl core NameInformation.GivenName)
                                                              Standard StatusNormative (from Normative)
                                                              Summarytrue
                                                              Requirements

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

                                                              Alternate Namesnl-core-NameInformation.GivenName
                                                              Invariantsele-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).

                                                              ShortContactInformation
                                                              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.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeContactPoint
                                                              Standard StatusNormative (from Normative)
                                                              Summarytrue
                                                              Requirements

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

                                                              Alternate NamesContactgegevens
                                                              Invariantsele-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())
                                                              SlicingThis 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 NametelephoneNumbers
                                                                Definition

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

                                                                ShortTelephoneNumbers
                                                                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.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeContactPoint(nl core ContactInformation TelephoneNumbers)
                                                                Standard StatusNormative (from Normative)
                                                                Summarytrue
                                                                Requirements

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

                                                                Alternate NamesTelefoonnummers, nl-core-ContactInformation-TelephoneNumbers
                                                                Invariantsele-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())
                                                                164. Patient.telecom:emailAddresses
                                                                Slice NameemailAddresses
                                                                Definition

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

                                                                ShortEmailAddresses
                                                                Comments

                                                                Implementation of the "EmailAddresses" concept of zib ContactInformation.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeContactPoint(nl core ContactInformation EmailAddresses)
                                                                Standard StatusNormative (from Normative)
                                                                Summarytrue
                                                                Requirements

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

                                                                Alternate NamesEmailAdressen, nl-core-ContactInformation-EmailAddresses
                                                                Invariantsele-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())
                                                                166. Patient.gender
                                                                Definition

                                                                Patient’s administrative gender.

                                                                ShortGender
                                                                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.

                                                                Control1..1
                                                                This element is affected by the following invariants: ele-1
                                                                BindingThe 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.

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

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

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

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                170. Patient.gender.extension
                                                                Definition

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension
                                                                Standard StatusNormative (from Normative)
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Patient.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 172. Patient.gender.extension:genderCodelist
                                                                  Slice NamegenderCodelist
                                                                  Definition

                                                                  Optional Extension Element - found in all resources.

                                                                  ShortOptional Extensions Element
                                                                  Comments

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

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(ext CodeSpecification) (Extension Type: CodeableConcept)
                                                                  Standard StatusNormative (from Normative)
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  174. 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.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  176. Patient.gender.extension:genderCodelist.extension
                                                                  Definition

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Standard StatusNormative (from Normative)
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Patient.gender.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 178. Patient.gender.extension:genderCodelist.url
                                                                    Definition

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

                                                                    Shortidentifies the meaning of the extension
                                                                    Comments

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

                                                                    Control1..1
                                                                    Typeuri
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification
                                                                    180. Patient.gender.extension:genderCodelist.value[x]
                                                                    Definition

                                                                    Patient’s administrative gender.

                                                                    ShortGender
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingThe codes SHALL be taken from GeslachtCodelijst
                                                                    (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20200901000000)

                                                                    GeslachtCodelijst

                                                                    TypeCodeableConcept
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Standard StatusNormative (from Normative)
                                                                    Alternate NamesGeslacht
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    182. Patient.gender.value
                                                                    Definition

                                                                    Primitive value for code

                                                                    ShortPrimitive value for code
                                                                    Control0..1
                                                                    Typecode
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Max Length:1048576
                                                                    184. 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.

                                                                    ShortDateOfBirth
                                                                    Comments

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

                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typedate
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

                                                                    Age of the individual drives many clinical processes.

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

                                                                    Indicates if the individual is deceased or not.

                                                                    ShortIndicates if the individual is deceased or not
                                                                    Comments

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

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

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

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                    • type @ $this
                                                                    • 188. Patient.deceased[x]:deceasedBoolean
                                                                      Slice NamedeceasedBoolean
                                                                      Definition

                                                                      An indication stating whether the patient has died.

                                                                      ShortDeathIndicator
                                                                      Comments

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

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

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

                                                                      Alternate NamesOverlijdensIndicator
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      190. Patient.deceased[x]:deceasedDateTime
                                                                      Slice NamedeceasedDateTime
                                                                      Definition

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

                                                                      ShortDateOfDeath
                                                                      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.

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

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

                                                                      Alternate NamesDatumOverlijden, OverlijdensIndicator
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      192. 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.

                                                                      ShortAddressInformation
                                                                      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 HP home both
                                                                      Visit Address/Woon-/verblijfadres PHYS home physical
                                                                      Temporary Address/Tijdelijk adres TMP temp
                                                                      Work Place/Werkadres WP work
                                                                      Vacation Home/Vakantie adres HV 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.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeAddress(nl core AddressInformation)
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Alternate NamesAdresgegevens, nl-core-AddressInformation
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      194. 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.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      196. Patient.address.extension
                                                                      Definition

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

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension
                                                                      Standard StatusNormative (from Normative)
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 198. Patient.address.extension:addressType
                                                                        Slice NameaddressType
                                                                        Definition

                                                                        Optional Extension Element - found in all resources.

                                                                        ShortOptional Extensions Element
                                                                        Comments

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(ext AddressInformation.AddressType) (Extension Type: CodeableConcept)
                                                                        Standard StatusNormative (from Normative)
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        200. Patient.address.use
                                                                        Definition

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

                                                                        ShortAddressType
                                                                        Comments

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        BindingThe 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.

                                                                        Typecode
                                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Alternate NamesAdresSoort
                                                                        Example<br/><b>General</b>:home
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        202. Patient.address.type
                                                                        Definition

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

                                                                        ShortAddressType
                                                                        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).

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        BindingThe 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.

                                                                        Typecode
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Alternate NamesAdresSoort
                                                                        Example<br/><b>General</b>:both
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        204. 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.

                                                                        ShortText 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.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        A renderable, unencoded form.

                                                                        Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        206. 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.

                                                                        ShortStreet 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]".

                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Example<br/><b>General</b>:137 Nowhere Street
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        208. Patient.address.line.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        210. Patient.address.line.extension
                                                                        Definition

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

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

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

                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        Standard StatusNormative (from Normative)
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on Patient.address.line.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 212. Patient.address.line.extension:streetName
                                                                          Slice NamestreetName
                                                                          Definition

                                                                          streetName.

                                                                          ShortstreetName
                                                                          Comments

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

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension(ADXP Street Name) (Extension Type: string)
                                                                          Standard StatusNormative (from Normative)
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          214. 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.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          216. Patient.address.line.extension:streetName.extension
                                                                          Definition

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

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

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

                                                                          Control0..0
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Standard StatusNormative (from Normative)
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 218. Patient.address.line.extension:streetName.url
                                                                            Definition

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

                                                                            Shortidentifies the meaning of the extension
                                                                            Comments

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

                                                                            Control1..1
                                                                            Typeuri
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName
                                                                            220. Patient.address.line.extension:streetName.value[x]
                                                                            Definition

                                                                            Street name of the address.

                                                                            ShortStreet
                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Standard StatusNormative (from Normative)
                                                                            Alternate NamesStraat
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            222. Patient.address.line.extension:houseNumber
                                                                            Slice NamehouseNumber
                                                                            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.

                                                                            ShorthouseNumber
                                                                            Comments

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

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension(ADXP House Number) (Extension Type: string)
                                                                            Standard StatusNormative (from Normative)
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            224. 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.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            226. Patient.address.line.extension:houseNumber.extension
                                                                            Definition

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

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

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

                                                                            Control0..0
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Standard StatusNormative (from Normative)
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 228. Patient.address.line.extension:houseNumber.url
                                                                              Definition

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

                                                                              Shortidentifies the meaning of the extension
                                                                              Comments

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

                                                                              Control1..1
                                                                              Typeuri
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber
                                                                              230. Patient.address.line.extension:houseNumber.value[x]
                                                                              Definition

                                                                              House number of the address.

                                                                              ShortHouseNumber
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Standard StatusNormative (from Normative)
                                                                              Alternate NamesHuisnummer
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              232. Patient.address.line.extension:houseNumberLetter-houseNumberAddition
                                                                              Slice NamehouseNumberLetter-houseNumberAddition
                                                                              Definition

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

                                                                              ShortbuildingNumberSuffix
                                                                              Comments

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

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(ADXP Building Number Suffix) (Extension Type: string)
                                                                              Standard StatusNormative (from Normative)
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              234. 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.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              236. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.extension
                                                                              Definition

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

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

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

                                                                              Control0..0
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Standard StatusNormative (from Normative)
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 238. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.url
                                                                                Definition

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

                                                                                Shortidentifies the meaning of the extension
                                                                                Comments

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

                                                                                Control1..1
                                                                                Typeuri
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix
                                                                                240. 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.

                                                                                ShortHouseNumberLetter / HouseNumberAddition
                                                                                Control1..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                Typestring
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Standard StatusNormative (from Normative)
                                                                                Alternate NamesHuisnummerletter, Huisnummertoevoeging
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                242. Patient.address.line.extension:houseNumberIndication
                                                                                Slice NamehouseNumberIndication
                                                                                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).

                                                                                ShortadditionalLocator
                                                                                Comments

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

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension(ADXP Additional Locator) (Extension Type: string)
                                                                                Standard StatusNormative (from Normative)
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                244. 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.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                246. Patient.address.line.extension:houseNumberIndication.extension
                                                                                Definition

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

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

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

                                                                                Control0..0
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Standard StatusNormative (from Normative)
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 248. Patient.address.line.extension:houseNumberIndication.url
                                                                                  Definition

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

                                                                                  Shortidentifies the meaning of the extension
                                                                                  Comments

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

                                                                                  Control1..1
                                                                                  Typeuri
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator
                                                                                  250. 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.

                                                                                  ShortHouseNumberIndication
                                                                                  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').

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typestring
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Standard StatusNormative (from Normative)
                                                                                  Alternate NamesAanduidingBijNummer
                                                                                  Invariantsele-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'))
                                                                                  252. Patient.address.line.extension:additionalInformation
                                                                                  Slice NameadditionalInformation
                                                                                  Definition

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

                                                                                  ShortunitID
                                                                                  Comments

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

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(ADXP Unit ID) (Extension Type: string)
                                                                                  Standard StatusNormative (from Normative)
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  254. 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.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  256. Patient.address.line.extension:additionalInformation.extension
                                                                                  Definition

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

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

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

                                                                                  Control0..0
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Standard StatusNormative (from Normative)
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 258. Patient.address.line.extension:additionalInformation.url
                                                                                    Definition

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

                                                                                    Shortidentifies the meaning of the extension
                                                                                    Comments

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

                                                                                    Control1..1
                                                                                    Typeuri
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
                                                                                    260. Patient.address.line.extension:additionalInformation.value[x]
                                                                                    Definition

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

                                                                                    ShortAdditionalInformation
                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Standard StatusNormative (from Normative)
                                                                                    Alternate NamesAdditioneleInformatie
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    262. Patient.address.line.value
                                                                                    Definition

                                                                                    Primitive value for string

                                                                                    ShortPrimitive value for string
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Max Length:1048576
                                                                                    264. 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).

                                                                                    ShortPlaceOfResidence
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Alternate NamesMunicpality, Woonplaats
                                                                                    Example<br/><b>General</b>:Erewhon
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    266. 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).

                                                                                    ShortMunicipality
                                                                                    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.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Alternate NamesCounty, Gemeente
                                                                                    Example<br/><b>General</b>:Madison
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    268. 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).

                                                                                    ShortSub-unit of country (abbreviations ok)
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Alternate NamesProvince, Territory
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    270. 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).

                                                                                    ShortPostcode
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Alternate NamesZip, Postcode
                                                                                    Example<br/><b>General</b>:9132
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    272. Patient.address.country
                                                                                    Definition

                                                                                    Country - a nation as commonly understood or generally accepted.

                                                                                    ShortCountry (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.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    274. Patient.address.country.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    276. Patient.address.country.extension
                                                                                    Definition

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

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

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

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Standard StatusNormative (from Normative)
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    SlicingThis element introduces a set of slices on Patient.address.country.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 278. Patient.address.country.extension:countryCode
                                                                                      Slice NamecountryCode
                                                                                      Definition

                                                                                      Optional Extension Element - found in all resources.

                                                                                      ShortOptional Extensions Element
                                                                                      Comments

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

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension(ext CodeSpecification) (Extension Type: CodeableConcept)
                                                                                      Standard StatusNormative (from Normative)
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      280. 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.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      282. Patient.address.country.extension:countryCode.extension
                                                                                      Definition

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

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

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

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Standard StatusNormative (from Normative)
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on Patient.address.country.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 284. Patient.address.country.extension:countryCode.url
                                                                                        Definition

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

                                                                                        Shortidentifies the meaning of the extension
                                                                                        Comments

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

                                                                                        Control1..1
                                                                                        Typeuri
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification
                                                                                        286. Patient.address.country.extension:countryCode.value[x]
                                                                                        Definition

                                                                                        Country in which the address is located.

                                                                                        ShortCountry
                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingThe codes SHALL be taken from LandCodelijsten
                                                                                        (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.10--20200901000000)
                                                                                        TypeCodeableConcept
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Standard StatusNormative (from Normative)
                                                                                        Alternate NamesLand
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        288. Patient.address.country.value
                                                                                        Definition

                                                                                        Primitive value for string

                                                                                        ShortPrimitive value for string
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Max Length:1048576
                                                                                        290. Patient.address.period
                                                                                        Definition

                                                                                        Time period when address was/is in use.

                                                                                        ShortTime period when address was/is in use
                                                                                        Comments

                                                                                        A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                        Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypePeriod
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Allows addresses to be placed in historical context.

                                                                                        Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                        292. Patient.maritalStatus
                                                                                        Definition

                                                                                        A person’s marital status according to the terms and definition in the Dutch civil code.

                                                                                        ShortMaritalStatus
                                                                                        Comments

                                                                                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingThe codes SHALL be taken from BurgerlijkeStaatCodelijst
                                                                                        (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20200901000000)

                                                                                        BurgerlijkeStaatCodelijst

                                                                                        TypeCodeableConcept
                                                                                        Requirements

                                                                                        Most, if not all systems capture it.

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

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

                                                                                        ShortWhether patient is part of a multiple birth
                                                                                        Comments

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

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeChoice of: boolean, integer
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Standard StatusNormative (from Normative)
                                                                                        Requirements

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

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        SlicingThis 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
                                                                                        • 296. Patient.multipleBirth[x]:multipleBirthBoolean
                                                                                          Slice NamemultipleBirthBoolean
                                                                                          Definition

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

                                                                                          ShortMultipleBirthIndicator
                                                                                          Comments

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

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          Typeboolean
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Standard StatusNormative (from Normative)
                                                                                          Requirements

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

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

                                                                                          Image of the patient.

                                                                                          ShortImage of the patient
                                                                                          Comments

                                                                                          Guidelines:

                                                                                          • Use id photos, not clinical photos.
                                                                                          • Limit dimensions to thumbnail.
                                                                                          • Keep byte count low to ease resource updates.
                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeAttachment
                                                                                          Requirements

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

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          att-1: If the Attachment has data, it SHALL have a contentType (data.empty() or contentType.exists())
                                                                                          300. Patient.contact
                                                                                          Definition

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

                                                                                          ShortContact
                                                                                          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.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeBackboneElement
                                                                                          Requirements

                                                                                          Need to track people you can contact about the patient.

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

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

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          304. Patient.contact.extension
                                                                                          Definition

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

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

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

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension
                                                                                          Standard StatusNormative (from Normative)
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          SlicingThis element introduces a set of slices on Patient.contact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 306. Patient.contact.extension:contactPerson
                                                                                            Slice NamecontactPerson
                                                                                            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.

                                                                                            ShortThis contact may have further details in this RelatedPerson
                                                                                            Comments

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

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension(Patient Related Person) (Extension Type: Reference(RelatedPerson))
                                                                                            Standard StatusNormative (from Normative)
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            308. 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.

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            310. Patient.contact.extension:contactPerson.extension
                                                                                            Definition

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

                                                                                            ShortAdditional content defined by implementations
                                                                                            Comments

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

                                                                                            Control0..0
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension
                                                                                            Standard StatusNormative (from Normative)
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            SlicingThis element introduces a set of slices on Patient.contact.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 312. Patient.contact.extension:contactPerson.url
                                                                                              Definition

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

                                                                                              Shortidentifies the meaning of the extension
                                                                                              Comments

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

                                                                                              Control1..1
                                                                                              Typeuri
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-relatedPerson
                                                                                              314. Patient.contact.extension:contactPerson.value[x]
                                                                                              Definition

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

                                                                                              ShortContact
                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeReference(RelatedPerson, nl core ContactPerson)
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Standard StatusNormative (from Normative)
                                                                                              Alternate NamesContactpersoon
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              316. Patient.contact.modifierExtension
                                                                                              Definition

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

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

                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                              Comments

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

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                              Summarytrue
                                                                                              Requirements

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

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

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

                                                                                              ShortThe kind of relationship
                                                                                              Comments

                                                                                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                                              (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                                                                              TypeCodeableConcept
                                                                                              Standard StatusNormative (from Normative)
                                                                                              Requirements

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

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              SlicingThis 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
                                                                                              • 320. Patient.contact.relationship:role
                                                                                                Slice Namerole
                                                                                                Definition

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

                                                                                                ShortRole
                                                                                                Comments

                                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingThe codes SHALL be taken from RolCodelijst
                                                                                                (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20200901000000)

                                                                                                RolCodelijst

                                                                                                TypeCodeableConcept
                                                                                                Standard StatusNormative (from Normative)
                                                                                                Requirements

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

                                                                                                Alternate NamesRol
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                322. Patient.contact.relationship:relationship
                                                                                                Slice Namerelationship
                                                                                                Definition

                                                                                                Defines the contact’s familial relationship to the patient.

                                                                                                ShortRelationship
                                                                                                Comments

                                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingThe codes SHALL be taken from RelatieCodelijst
                                                                                                (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20200901000000)

                                                                                                RelatieCodelijst

                                                                                                TypeCodeableConcept
                                                                                                Standard StatusNormative (from Normative)
                                                                                                Requirements

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

                                                                                                Alternate NamesRelatie
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                324. 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.

                                                                                                ShortNameInformation
                                                                                                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.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeHumanName(nl core NameInformation)
                                                                                                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 NamesNaamgegevens, nl-core-NameInformation
                                                                                                Invariantsele-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())
                                                                                                326. Patient.contact.telecom
                                                                                                Definition

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

                                                                                                ShortContactInformation
                                                                                                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.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeContactPoint
                                                                                                Standard StatusNormative (from Normative)
                                                                                                Requirements

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

                                                                                                Alternate NamesContactgegevens
                                                                                                Invariantsele-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())
                                                                                                SlicingThis 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
                                                                                                • 328. Patient.contact.telecom:telephoneNumbers
                                                                                                  Slice NametelephoneNumbers
                                                                                                  Definition

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

                                                                                                  ShortTelephoneNumbers
                                                                                                  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.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeContactPoint(nl core ContactInformation TelephoneNumbers)
                                                                                                  Standard StatusNormative (from Normative)
                                                                                                  Requirements

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

                                                                                                  Alternate NamesTelefoonnummers, nl-core-ContactInformation-TelephoneNumbers
                                                                                                  Invariantsele-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())
                                                                                                  330. Patient.contact.telecom:emailAddresses
                                                                                                  Slice NameemailAddresses
                                                                                                  Definition

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

                                                                                                  ShortEmailAddresses
                                                                                                  Comments

                                                                                                  Implementation of the "EmailAddresses" concept of zib ContactInformation.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeContactPoint(nl core ContactInformation EmailAddresses)
                                                                                                  Standard StatusNormative (from Normative)
                                                                                                  Requirements

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

                                                                                                  Alternate NamesEmailAdressen, nl-core-ContactInformation-EmailAddresses
                                                                                                  Invariantsele-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())
                                                                                                  332. Patient.contact.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.

                                                                                                  ShortAddressInformation
                                                                                                  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.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeAddress(nl core AddressInformation)
                                                                                                  Requirements

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

                                                                                                  Alternate NamesAdresgegevens, nl-core-AddressInformation
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  334. Patient.contact.gender
                                                                                                  Definition

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

                                                                                                  Shortmale | female | other | unknown
                                                                                                  Comments

                                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingThe codes SHALL be taken from AdministrativeGender
                                                                                                  (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                                                                                  The gender of a person used for administrative purposes.

                                                                                                  Typecode
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Requirements

                                                                                                  Needed to address the person correctly.

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

                                                                                                  Organization on behalf of which the contact is acting or for which the contact is working.

                                                                                                  ShortOrganization that is associated with the contact
                                                                                                  Comments

                                                                                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1, pat-1
                                                                                                  TypeReference(Organization)
                                                                                                  Requirements

                                                                                                  For guardians or business related contacts, the organization is relevant.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                  338. Patient.contact.period
                                                                                                  Definition

                                                                                                  The period during which this contact person or organization is valid to be contacted relating to this patient.

                                                                                                  ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                                                  Comments

                                                                                                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                  Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypePeriod
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                                  340. Patient.communication
                                                                                                  Definition

                                                                                                  A language which may be used to communicate with the patient about his or her health.

                                                                                                  ShortLanguageProficiency
                                                                                                  Comments

                                                                                                  If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeBackboneElement
                                                                                                  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 NamesTaalvaardigheid
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  342. Patient.communication.id
                                                                                                  Definition

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

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  344. Patient.communication.extension
                                                                                                  Definition

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

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

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

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension
                                                                                                  Standard StatusNormative (from Normative)
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on Patient.communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 346. Patient.communication.extension:languageControl
                                                                                                    Slice NamelanguageControl
                                                                                                    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.

                                                                                                    ShortLanguageControlListening / 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)
                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension(Patient Proficiency) (Complex Extension)
                                                                                                    Standard StatusNormative (from Normative)
                                                                                                    Alternate Namesextensions, user content, TaalvaardigheidBegrijpen, TaalvaardigheidSpreken, TaalvaardigheidLezen
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    348. 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.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    350. Patient.communication.extension:languageControl.extension
                                                                                                    Definition

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

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

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

                                                                                                    Control2..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension
                                                                                                    Standard StatusNormative (from Normative)
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    SlicingThis element introduces a set of slices on Patient.communication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 352. Patient.communication.extension:languageControl.extension:level
                                                                                                      Slice Namelevel
                                                                                                      Definition

                                                                                                      How well the patient can communicate this communication (good, poor, etc.).

                                                                                                      ShortThe proficiency level of the communication
                                                                                                      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.

                                                                                                      Control1..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeExtension
                                                                                                      Standard StatusNormative (from Normative)
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      354. 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.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      356. Patient.communication.extension:languageControl.extension:level.extension
                                                                                                      Definition

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

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

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

                                                                                                      Control0..0
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeExtension
                                                                                                      Standard StatusNormative (from Normative)
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      SlicingThis element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 358. Patient.communication.extension:languageControl.extension:level.url
                                                                                                        Definition

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

                                                                                                        Shortidentifies the meaning of the extension
                                                                                                        Comments

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

                                                                                                        Control1..1
                                                                                                        Typeuri
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Fixed Valuelevel
                                                                                                        360. 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).

                                                                                                        ShortValue of extension
                                                                                                        Comments

                                                                                                        The zib ValueSets TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidSprekenCodelijst and TaalvaardigheidLezenCodelijst are equal to the default FHIR ValueSet.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        BindingThe codes SHALL be taken from LanguageAbilityProficiency
                                                                                                        (required to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityProficiency)

                                                                                                        The proficiency level for the communication.

                                                                                                        TypeCoding
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        Standard StatusNormative (from Normative)
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        362. Patient.communication.extension:languageControl.extension:type
                                                                                                        Slice Nametype
                                                                                                        Definition

                                                                                                        What type of communication for the proficiency (spoken, written, etc.).

                                                                                                        ShortThe proficiency type of the communication
                                                                                                        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.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension
                                                                                                        Standard StatusNormative (from Normative)
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        364. 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.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        366. Patient.communication.extension:languageControl.extension:type.extension
                                                                                                        Definition

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

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

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

                                                                                                        Control0..0
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension
                                                                                                        Standard StatusNormative (from Normative)
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        SlicingThis element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 368. Patient.communication.extension:languageControl.extension:type.url
                                                                                                          Definition

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

                                                                                                          Shortidentifies the meaning of the extension
                                                                                                          Comments

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

                                                                                                          Control1..1
                                                                                                          Typeuri
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Fixed Valuetype
                                                                                                          370. 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).

                                                                                                          ShortValue of extension
                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          BindingThe codes SHOULD be taken from LanguageAbilityMode
                                                                                                          (preferred to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityMode)

                                                                                                          The proficiency type for the communication.

                                                                                                          TypeCoding
                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                          Standard StatusNormative (from Normative)
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          372. Patient.communication.extension:languageControl.url
                                                                                                          Definition

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

                                                                                                          Shortidentifies the meaning of the extension
                                                                                                          Comments

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

                                                                                                          Control1..1
                                                                                                          Typeuri
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-proficiency
                                                                                                          374. 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).

                                                                                                          ShortValue of extension
                                                                                                          Control0..0
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeChoice 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
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Standard StatusNormative (from Normative)
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          376. Patient.communication.extension:communicationDetails
                                                                                                          Slice NamecommunicationDetails
                                                                                                          Definition

                                                                                                          Optional Extension Element - found in all resources.

                                                                                                          ShortOptional Extensions Element
                                                                                                          Comments

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

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension(ext LanguageProficiency.CommunicationDetails) (Extension Type: CodeableConcept)
                                                                                                          Standard StatusNormative (from Normative)
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          378. Patient.communication.extension:comment
                                                                                                          Slice Namecomment
                                                                                                          Definition

                                                                                                          Optional Extension Element - found in all resources.

                                                                                                          ShortOptional Extensions Element
                                                                                                          Comments

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

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension(ext Comment) (Extension Type: string)
                                                                                                          Standard StatusNormative (from Normative)
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          380. 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.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          382. Patient.communication.extension:comment.extension
                                                                                                          Definition

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

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

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

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension
                                                                                                          Standard StatusNormative (from Normative)
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on Patient.communication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 384. Patient.communication.extension:comment.url
                                                                                                            Definition

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

                                                                                                            Shortidentifies the meaning of the extension
                                                                                                            Comments

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

                                                                                                            Control1..1
                                                                                                            Typeuri
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Comment
                                                                                                            386. 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.

                                                                                                            ShortComment
                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typestring
                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Standard StatusNormative (from Normative)
                                                                                                            Alternate NamesToelichting
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            388. Patient.communication.modifierExtension
                                                                                                            Definition

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

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

                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                            Comments

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

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension
                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                            Summarytrue
                                                                                                            Requirements

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

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

                                                                                                            The language of communication.

                                                                                                            ShortCommunicationLanguage
                                                                                                            Comments

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

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            BindingThe codes SHALL be taken from CommunicatieTaalCodelijst
                                                                                                            (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.12.2--20200901000000)

                                                                                                            CommunicatieTaalCodelijst

                                                                                                            Additional BindingsPurpose
                                                                                                            AllLanguagesMax Binding
                                                                                                            TypeCodeableConcept
                                                                                                            Requirements

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

                                                                                                            Alternate NamesCommunicatieTaal
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            392. Patient.communication.preferred
                                                                                                            Definition

                                                                                                            Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

                                                                                                            ShortLanguage preference indicator
                                                                                                            Comments

                                                                                                            This language is specifically identified for communicating healthcare information.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typeboolean
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Requirements

                                                                                                            People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

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

                                                                                                            A reference from one resource to another.

                                                                                                            ShortA reference from one resource to another
                                                                                                            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.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeReference(Reference)(Organization, Practitioner, PractitionerRole, nl core HealthProfessional PractitionerRole)
                                                                                                            Alternate NamescareProvider
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                            396. Patient.managingOrganization
                                                                                                            Definition

                                                                                                            Organization that is the custodian of the patient record.

                                                                                                            ShortOrganization that is the custodian of the patient record
                                                                                                            Comments

                                                                                                            There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeReference(Organization)
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to know who recognizes this patient record, manages and updates it.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                            398. Patient.link
                                                                                                            Definition

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

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

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

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeBackboneElement
                                                                                                            Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            There are multiple use cases:

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

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

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

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

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

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

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension
                                                                                                            Standard StatusNormative (from Normative)
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            SlicingThis element introduces a set of slices on Patient.link.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 404. Patient.link.modifierExtension
                                                                                                              Definition

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

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

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

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

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension
                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                              Summarytrue
                                                                                                              Requirements

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

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

                                                                                                              The other patient resource that the link refers to.

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

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

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeReference(Patient, RelatedPerson)
                                                                                                              Summarytrue
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                              408. Patient.link.type
                                                                                                              Definition

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

                                                                                                              Shortreplaced-by | replaces | refer | seealso
                                                                                                              Comments

                                                                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              BindingThe codes SHALL be taken from LinkType
                                                                                                              (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

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