HDBP0037-Patient

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.

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.

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.

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.

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

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

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

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.

Identifies the purpose for this name.

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

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

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.

A renderable, unencoded form.

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.

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.

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.

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.

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.

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 CBB concept 'titles' is mapped to elements HumanName.prefix and HumanName.suffix. Semantically this mapping is not complete: the CBB 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 CBB 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.

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

The CBB concept 'titles' is mapped to elements HumanName.prefix and HumanName.suffix. Semantically this mapping is not complete: the CBB 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 CBB 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.

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

Allows names to be placed in historical context.

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.

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

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

This .name element represents the Belgian given name ("roepnaam") according to the CBB NameInformation.

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 CBB is mapped to FHIR.

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

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

Implementation of the CBB ContactInformation.

Please note that this profile differs significantly from the zib ContactInformation because the zib model is deemed overly complex, too Dutch-specific, and contains unsuited terminology. The mapping from zib to FHIR is not trivial and results in too complex mapping. Therefore, the CBB is redesigned based on what is implemented internationally and in Belgium by looking at the FHIR data type and eHealth core profiles. The new model replaces the containers for phone numbers and email addresses with elements on the root that can capture both. Therefore, no need for two profiles, slicing in the host profiles and no ConceptMaps.

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.

An indication stating whether the patient has died.

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.

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

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 CBB 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 Human Language of the item.

This is used where an item may repeat to indicate the language of each repeat.

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

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

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

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).

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.

A renderable, unencoded form.

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.

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.

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.

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.

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.

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.

A geographically determined area which forms part of the municipal area.

Note that FHIR strings SHALL NOT exceed 1MB in size

Municipality of residence.

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.

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).

Note that FHIR strings SHALL NOT exceed 1MB in size

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.

Time period when address was/is in use.

Allows addresses to be placed in historical context.

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.

A person’s marital status.

Most, if not all systems capture it.

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.

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

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

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).

An indication of the birth order in case the patient is of a multiple birth.

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

The CBB recognizes both the MultipleBirthIndicator (boolean) and MultipleBirthOrder (integer) concepts, whereas in FHIR only one of these concepts may be present. Therefore, if multipleBirthInteger is present and has a value, its value can be mapped to MultipleBirthOrder and MultipleBirthIndicator is assumed to be true.

Image of the patient.

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

Guidelines:

• Use id photos, not clinical photos.
• Limit dimensions to thumbnail.
• Keep byte count low to ease resource updates.

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.

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

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

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.

Defines the contact’s familial relationship to the patient.

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

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.

Full name of the contact.

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

This element can and should not completely capture the NameInformation concept from the CBB 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 name information should instead be captured using an instance of HdBe-ContactPerson, which can then be referenced from this resource. See the comment on Patient.contact for more information.

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

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

Implementation of the CBB ContactInformation.

Please note that this profile differs significantly from the zib ContactInformation because the zib model is deemed overly complex, too Dutch-specific, and contains unsuited terminology. The mapping from zib to FHIR is not trivial and results in too complex mapping. Therefore, the CBB is redesigned based on what is implemented internationally and in Belgium by looking at the FHIR data type and eHealth core profiles. The new model replaces the containers for phone numbers and email addresses with elements on the root that can capture both. Therefore, no need for two profiles, slicing in the host profiles and no ConceptMaps.

Contact’s address information.

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

This element can and should not completely capture the AddressInformation concept from CBB 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 HdBe-ContactPerson, which can then be referenced from this resource. See the comment on Patient.contact for more information.

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

Needed to address the person correctly.

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

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.

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

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.

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

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

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.

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

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.

This language is specifically identified for communicating healthcare information.

Patient's nominated care provider.

This 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.

Organization that is the custodian of the patient record.

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

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).

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.