This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions 
Detailed Descriptions for the elements in the Patient resource.
Demographics and other administrative information about an individual or animal that is the subject of potential, past, current, or future health-related care, services, or processes.
Short DisplayInformation about an individual or animal receiving health care services Cardinality0..* TypeDomainResource RequirementsTracking patient is the center of the healthcare process.
Alternate NamesSubjectOfCare Client Resident Summaryfalse Patient.identifier Element IdPatient.identifier DefinitionAn identifier for this patient.
Short DisplayAn identifier for this patient NoteThis is a business identifier, not a resource identifier (see discussion) Cardinality0..* TypeIdentifier RequirementsPatients are almost always assigned specific numerical identifiers.
Summarytrue Patient.active Element IdPatient.active DefinitionWhether this patient record is in active use.Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.
It is often used to filter patient lists to exclude inactive patients
Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Short DisplayWhether this patient's record is in active use Cardinality0..1 Typeboolean Is Modifiertrue (Reason: 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) Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element RequirementsNeed to be able to mark a patient record as not to be used because it was created in error.
Summarytrue CommentsIf a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Patient.name Element IdPatient.name DefinitionA name associated with the individual.
Short DisplayA name associated with the patient Cardinality0..* TypeHumanName RequirementsNeed to be able to track the patient by multiple names. Examples are your official name and a partner name.
Summarytrue CommentsA 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. Animal names may be communicated as given names, and optionally may include a family name.
Patient.telecom Element IdPatient.telecom DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short DisplayA contact detail for the individual Cardinality0..* TypeContactPoint RequirementsPeople have (primary) ways to contact them in some way such as phone, email.
Summarytrue CommentsA 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).
Patient.gender Element IdPatient.gender DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
See the Patient Gender and Sex section for additional information about communicating patient gender and sex.
Short Displaymale | female | other | unknown Cardinality0..1 Terminology BindingAdministrativeGender (Required) Typecode RequirementsNeeded for identification of the individual, in combination with (at least) name and birth date.
Summarytrue CommentsThe 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.
Patient.birthDate Element IdPatient.birthDate DefinitionThe date of birth for the individual.
Age of the individual drives many clinical processes.
Summarytrue CommentsPartial dates are allowed if the specific date of birth 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).
LOINC Code21112-8 Patient.deceased[x] Element IdPatient.deceased[x] DefinitionIndicates if the individual is deceased or not.
Short DisplayIndicates if the individual is deceased or not Cardinality0..1 Typeboolean|dateTime [x] NoteSee Choice of Datatypes for further information about how to use [x] Is Modifiertrue (Reason: 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.) RequirementsThe 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.
Summarytrue CommentsIf 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.
Patient.address Element IdPatient.address DefinitionAn address for the individual.
Short DisplayAn address for the individual Cardinality0..* TypeAddress RequirementsMay need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Summarytrue CommentsPatient may have multiple addresses with different uses or applicable periods.
Patient.maritalStatus Element IdPatient.maritalStatus DefinitionThis field contains a patient's most recent marital (civil) status.
Short DisplayMarital (civil) status of a patient Cardinality0..1 Terminology BindingMarital Status Codes (Extensible) TypeCodeableConcept RequirementsMost, if not all systems capture it.
Summaryfalse Patient.multipleBirth[x] Element IdPatient.multipleBirth[x] DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). This count is relative to the total of live births and fetal losses.
Short DisplayWhether patient is part of a multiple birth Cardinality0..1 Typeboolean|integer [x] NoteSee Choice of Datatypes for further information about how to use [x] RequirementsFor disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Summaryfalse CommentsWhere 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).
Patient.photo Element IdPatient.photo DefinitionImage of the patient.
Short DisplayImage of the patient Cardinality0..* TypeAttachment RequirementsMany EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Summaryfalse CommentsGuidelines:
- Use id photos, not clinical photos.
- Limit dimensions to thumbnail.
- Keep byte count low to ease resource updates.
A contact party (e.g. guardian, partner, friend) for the patient.
Short DisplayA contact party (e.g. guardian, partner, friend) for the patient Cardinality0..* RequirementsNeed to track people you can contact about the patient.
Summaryfalse CommentsContact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Invariants| Defined on this element | |||
| pat-1 | Rule | 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() |
The nature of the personal relationship between the patient and the contact person.
Short DisplayThe kind of personal relationship Cardinality0..* Terminology BindingPersonalRelationshipRoleType (Preferred) TypeCodeableConcept RequirementsUsed to determine the nature of the personal relationship between the patient and the contact person.
Summaryfalse CommentsThis property is for personal relationships. Functional relationships would be represented in Patient.contact.role.
The nature of the functional role between the patient and the contact person.
Short DisplayThe kind of functional role Cardinality0..* Terminology BindingPatient Relationship Type (Preferred) TypeCodeableConcept RequirementsUsed to determine which contact person is the most relevant to approach, depending on circ*mstances.
Summaryfalse CommentsThis property is for functional relationships. Personal relationships would be represented in Patient.contact.relationship.
A name associated with the contact person. Alternate/additional names for this contact can be found in the additionalName property.
Contact persons need to be identified by name. Where multiple names are required, such as legal name and usual (Name to Use) name, also refer to the additionalName property.
| Affect this element | |||
| pat-1 | Rule | 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() |
Additional names for the contact person.
Short DisplayAdditional names for the contact person Cardinality0..* TypeHumanName Summaryfalse CommentsTo maintain backward compatibility, additionalName was added as a way to express names beyond the single name that can be represented in Patient.contact.name.
When looking for an name of a given type, implementers should inspect both Patient.contact.name and Patient.contact.additionalName, and treat those two properties as a single combined logical list of names.
A contact detail for the person, e.g. a telephone number or an email address.
Short DisplayA contact detail for the person Cardinality0..* TypeContactPoint RequirementsPeople have (primary) ways to contact them in some way such as phone, email.
Summaryfalse CommentsContact 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.
Invariants| Affect this element | |||
| pat-1 | Rule | 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() |
Address for the contact person. Alternate/additional addresses for this contact can be found in the additionalAddress property.
Need to keep track where the contact person can be contacted per postal mail or visited.
Summaryfalse Invariants| Affect this element | |||
| pat-1 | Rule | 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() |
Additional addresses for the contact person.
Short DisplayAdditional addresses for the contact person Cardinality0..* TypeAddress RequirementsNeed to keep track where the contact person can be contacted per postal mail or visited.
Summaryfalse CommentsTo maintain backward compatibility, additionalAddress was added as a way to express addresses beyond the single address that can be represented in Patient.contact.address.
When looking for an address of a given type, implementers should inspect both Patient.contact.address and Patient.contact.additionalAddress, and treat those two properties as a single combined logical list of addresses.
Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Short Displaymale | female | other | unknown Cardinality0..1 Terminology BindingAdministrativeGender (Required) Typecode RequirementsNeeded to address the person correctly.
Summaryfalse Patient.contact.organization Element IdPatient.contact.organization DefinitionOrganization on behalf of which the contact is acting or for which the contact is working.
Short DisplayOrganization that is associated with the contact Cardinality0..1 TypeReference(Organization) RequirementsFor guardians or business related contacts, the organization is relevant.
Summaryfalse Invariants| Affect this element | |||
| pat-1 | Rule | 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() |
The period during which this contact person or organization is valid to be contacted relating to this patient.
Short DisplayThe period during which this contact person or organization is valid to be contacted relating to this patient Cardinality0..1 TypePeriod Summaryfalse Patient.communication Element IdPatient.communication DefinitionA language which may be used to communicate with the patient about his or her health.
Short DisplayA language which may be used to communicate with the patient about his or her health Cardinality0..* RequirementsIf 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.
Summaryfalse CommentsIf 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.
Patient.communication.language Element IdPatient.communication.language DefinitionThe language which may be used to communicate with the individual.
Short DisplayThe language which can be used to communicate with the patient about his or her health Cardinality1..1 Terminology BindingAll Languages (Required)| Additional Bindings | Purpose |
| Common Languages | Starter Set |
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Summaryfalse CommentsThe language is commonly represented using the ISO-639-1 alpha code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha code for the region in upper case. For example, "en" for English, or "en-US" for American English versus "en-AU" for Australian English, sgn-US for American Sign Language, sgn-NL for Dutch Sign Language, etc.
Not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Patient.communication.preferred Element IdPatient.communication.preferred DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Short DisplayLanguage preference indicator Cardinality0..1 Typeboolean RequirementsPeople 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.
Summaryfalse CommentsThis language is specifically identified for communicating healthcare information.
Patient.generalPractitioner Element IdPatient.generalPractitioner DefinitionPatient's nominated care provider.
Short DisplayPatient's nominated primary care provider Cardinality0..* TypeReference(Organization | Practitioner | PractitionerRole) Alternate NamescareProvider Summaryfalse CommentsThis may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.
Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Patient.managingOrganization Element IdPatient.managingOrganization DefinitionOrganization that is the custodian of the patient record.
Short DisplayOrganization that is the custodian of the patient record Cardinality0..1 TypeReference(Organization) RequirementsNeed to know who recognizes this patient record, manages and updates it.
Summarytrue CommentsThere 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).
Patient.link Element IdPatient.link DefinitionLink to a Patient or RelatedPerson resource that concerns the same actual individual.
Short DisplayLink to a Patient or RelatedPerson resource that concerns the same actual individual Cardinality0..* Is Modifiertrue (Reason: 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') RequirementsThere 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.
There is no assumption that linked patient records have mutual links.
Patient.link.other Element IdPatient.link.other DefinitionLink to a Patient or RelatedPerson resource that concerns the same actual individual.
Short DisplayThe other patient or related person resource that the link refers to Cardinality1..1 TypeReference(Patient | RelatedPerson) HierarchyThis reference may point back to the same instance (including transitively) Summarytrue CommentsReferencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Patient.link.type Element IdPatient.link.type DefinitionThe type of link between this patient resource and another patient resource.
Short Displayreplaced-by | replaces | refer | seealso Cardinality1..1 Terminology BindingLink Type (Required) Typecode Summarytrue