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

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.

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.

The nationality of the patient.

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.

Code representing nationality of patient.

An Extension

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

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.

Indicates the country of citizenship.

Period when nationality was effective.

An Extension

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

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.

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

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

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.

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

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).

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.

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.

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.

Patients are almost always assigned specific numerical identifiers.

An identifier for this patient.

Patients are almost always assigned specific numerical identifiers.

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.

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

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

Patient's full name.

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.

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

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

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.

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

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

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.

An Extension

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

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.

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

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

Identifies the purpose for this name.

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

The use of a human name.

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

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

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.

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.

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.

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

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

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

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.

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

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.

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

Identifies the purpose for this name.

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

The use of a human name.

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

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.

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

The name normally used to address the person.

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.

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

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

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

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.

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

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

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.

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

Optional Extension Element - found in all resources.

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

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.

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

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

Optional Extension Element - found in all resources.

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

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.

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

The person's telephone number.

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

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

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

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

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

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

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

Implementation of the "EmailAddresses" concept of zib ContactInformation.

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

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

Telecommunications form for contact point.

The person's e-mail address

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

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

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

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

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

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

Patient’s administrative gender.

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.

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

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

Optional Extension Element - found in all resources.

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

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.

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

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).

Age of the individual drives many clinical processes.

Indicates if the individual is deceased or not.

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.

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.

An indication stating whether the patient has died.

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.

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.

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

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.

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.

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.

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.

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.

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

Optional Extension Element - found in all resources.

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.

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

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

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

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

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

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).

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

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).

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).

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.

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).

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

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).

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

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

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).

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

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

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

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.

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).

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.

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.

The other patient resource that the link refers to.

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

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

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

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

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

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

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

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.

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.

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.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

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.

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.

The nationality of the patient.

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.

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

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.

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.

Code representing nationality of patient.

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

An Extension

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

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.

Indicates the country of citizenship.

Period when nationality was effective.

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

An Extension

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

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.

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

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