Generated Narrative: StructureDefinition br-core-patient Name Flags Card. Type Description & Constraints Patient Patient id 0..1 id Identificador literal deste recurso meta 0..1 Meta Metadados sobre o recurso implicitRules 0..1 uri URI(s) sob as quais este recurso é conhecido language 0..1 code Linguagem do recurso text 0..1 Narrative Texto narrativo, 72 caracteres para resumo contained 0..* Resource Recursos contidos Slices for extension 1..* Extension Extensões adicionais Slice: Unordered, Open by value:url localNascimento 0..1 Address Local de nascimento do paciente URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace identidadeGenero 0..1 CodeableConcept Identidade de gênero do paciente URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by https://ips.saude.gov.br/fhir/StructureDefinition/identidade-genero-br-ips Binding: BRIdentidadeGenero (required) raca 1..1 CodeableConcept Raça do paciente URL: https://ips.saude.gov.br/fhir/StructureDefinition/raca-br-ips Binding: RaçaCor (required): Raça povoIndigena 0..1 CodeableConcept Afiliação do paciente URL: https://ips.saude.gov.br/fhir/StructureDefinition/povo-indigena-br-ips Binding: Etnia Indígena (extensible): Povo indígena sexoNascimento 0..1 CodeableConcept Sexo do nascimento do paciente URL: https://ips.saude.gov.br/fhir/StructureDefinition/sexo-nascimento-br-ips Binding: BRSexoNascimento (required) povoTradicional 0..1 CodeableConcept Extensão de populacao tradicional do Core do Brasil URL: https://br-core.saude.gov.br/fhir/StructureDefinition/br-core-populacaotradicional Binding: Populacao Tradicional (required): População tradicional povoItinerante 0..1 CodeableConcept Extensão de povo intinerante do Core do Brasil URL: https://br-core.saude.gov.br/fhir/StructureDefinition/br-core-povoitinerante Binding: BRPovoItinerante (required): Povo itinerante modifierExtension 0..* Extension Extensões adicionais Slices for identifier 1..* Identifier Identificadores nacionais do paciente Slice: Unordered, Open by value:system identifier:cns 0..1 Identifier Identificador do paciente id 0..1 string Id lógico do identificador do paciente extension 0..* Extension Extensões do identificador do paciente use 1..1 code Uso do identificador do paciente Fixed Value: official type 1..1 CodeableConcept Tipo do identificador do paciente Binding: Tipo de Documento do Indivíduo (required) id 0..1 string Id lógico do tipo do identificador do paciente extension 0..* Extension Extensões do tipo do identificador do paciente coding 1..1 Coding Codificação do tipo do identificador do paciente id 0..1 string Id lógico da codificação do tipo do identificador do paciente extension 0..* Extension Extensões da codificação do tipo do identificador do paciente system 1..1 uri Sistema da codificação do tipo do identificador do paciente Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 version 0..1 string Versão da codificação do tipo do identificador do paciente code 1..1 code Código da codificação do tipo do identificador do paciente Fixed Value: HC display 0..1 string Texto da codificação do tipo do identificador do paciente userSelected 0..1 boolean Seleção do usuário da codificação do tipo do identificador do paciente text 0..1 string Texto do tipo do identificador do paciente system 1..1 uri Sistema do identificador do paciente Fixed Value: https://saude.gov.br/fhir/sid/cns value 1..1 string Valor do identificador do paciente period 0..1 Period Período de uso do identificador do paciente assigner 0..1 Reference(BRCoreOrganization) Entidade que atribuiu o identificador do paciente display 0..1 string Nome da entidade que atribuiu o identificador do paciente identifier:cpf 1..1 Identifier Identificador do paciente id 0..1 string Id lógico do identificador do paciente extension 0..* Extension Extensões do identificador do paciente use 1..1 code Uso do identificador do paciente Fixed Value: official type 0..1 CodeableConcept Tipo do identificador do paciente Binding: Tipo de Documento do Indivíduo (required) id 0..1 string Id lógico do tipo do identificador do paciente extension 0..* Extension Extensões do tipo do identificador do paciente coding 1..1 Coding Codificação do tipo do identificador do paciente id 0..1 string Id lógico da codificação do tipo do identificador do paciente extension 0..* Extension Extensões da codificação do tipo do identificador do paciente system 1..1 uri Sistema da codificação do tipo do identificador do paciente Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 version 0..1 string Versão da codificação do tipo do identificador do paciente code 1..1 code Código da codificação do tipo do identificador do paciente Fixed Value: TAX display 0..1 string Texto da codificação do tipo do identificador do paciente userSelected 0..1 boolean Seleção do usuário da codificação do tipo do identificador do paciente text 0..1 string Texto do tipo do identificador do paciente system 1..1 uri Sistema do identificador do paciente Fixed Value: https://saude.gov.br/fhir/sid/cpf value 1..1 string Valor do identificador do paciente period 0..1 Period Período de uso do identificador do paciente assigner 0..1 Reference(BRCoreOrganization) Entidade que atribuiu o identificador do paciente display 0..1 string Nome da entidade que atribuiu o identificador do paciente identifier:registroEstrangeiro 0..1 Identifier Identificador do paciente id 0..1 string Id lógico do identificador do paciente extension 0..* Extension Extensões do identificador do paciente use 0..1 code Uso do identificador do paciente Fixed Value: official type 0..1 CodeableConcept Tipo do identificador do paciente Binding: Tipo de Documento do Indivíduo (required) id 0..1 string Id lógico do tipo do identificador do paciente extension 0..* Extension Extensões do tipo do identificador do paciente coding 1..1 Coding Codificação do tipo do identificador do paciente id 0..1 string Id lógico da codificação do tipo do identificador do paciente extension 0..* Extension Extensões da codificação do tipo do identificador do paciente system 1..1 uri Sistema da codificação do tipo do identificador do paciente Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 version 0..1 string Versão da codificação do tipo do identificador do paciente code 1..1 code Código da codificação do tipo do identificador do paciente Fixed Value: RNE display 0..1 string Texto da codificação do tipo do identificador do paciente userSelected 0..1 boolean Seleção do usuário da codificação do tipo do identificador do paciente text 0..1 string Texto do tipo do identificador do paciente system 1..1 uri Sistema do identificador do paciente Fixed Value: https://saude.gov.br/fhir/sid/rne value 1..1 string Valor do identificador do paciente period 0..1 Period Período de uso do identificador do paciente assigner 0..1 Reference(Organization) Entidade que atribuiu o identificador do paciente display 0..1 string Nome da entidade que atribuiu o identificador do paciente identifier:passaporte 0..1 Identifier Identificador do paciente id 0..1 string Id lógico do identificador do paciente extension 0..* Extension Extensões do identificador do paciente use 0..1 code Uso do identificador do paciente Fixed Value: official type 0..1 CodeableConcept Tipo do identificador do paciente Binding: Tipo de Documento do Indivíduo (required): Tipo do identificador do paciente id 0..1 string Id lógico do tipo do identificador do paciente extension 0..* Extension Extensões do tipo do identificador do paciente coding 1..1 Coding Codificação do tipo do identificador do paciente id 0..1 string Id lógico da codificação do tipo do identificador do paciente extension 0..* Extension Extensões da codificação do tipo do identificador do paciente system 1..1 uri Sistema da codificação do tipo do identificador do paciente Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 version 0..1 string Versão da codificação do tipo do identificador do paciente code 1..1 code Código da codificação do tipo do identificador do paciente Fixed Value: PPN display 0..1 string Texto da codificação do tipo do identificador do paciente userSelected 0..1 boolean Seleção do usuário da codificação do tipo do identificador do paciente text 0..1 string Texto do tipo do identificador do paciente system 1..1 uri Sistema do identificador do paciente Fixed Value: http://hl7.org/fhir/sid/passport-BRA value 1..1 string Valor do identificador do paciente period 0..1 Period Período de uso do identificador do paciente assigner 0..1 Reference(BRCoreOrganization) Entidade que atribuiu o identificador do paciente display 0..1 string Nome da entidade que atribuiu o identificador do paciente active 0..1 boolean Indica se o paciente está ativo name C 0..* HumanName Nome do paciente br-core-pat-1: Patient.name.given, Patient.name.family, Patient.name.text or Patient.name.extension SHALL be present id 0..1 string Identificador primário deste recurso extension 0..* Extension Extensões adicionais use 0..1 code Uso do nome text 0..1 string Representação textual do nome completo do paciente family 0..1 string Sobrenome given 0..* string Nome completo do paciente prefix 0..* string Prefixo do nome suffix 0..* string Sufixo do nome period 0..1 Period Período de tempo em que o nome foi usado telecom 0..* ContactPoint Contatos de telecomunicação do paciente id 0..1 string Identificador primário deste recurso extension 0..* Extension Extensões adicionais system 0..1 code Sistema de telecomunicação usado para o contato value 0..1 string Número ou do contato use 0..1 code Uso do contato rank 0..1 positiveInt Indica a ordem de preferência do contato period 0..1 Period Período de tempo em que o contato foi usado gender 1..1 code Sexo birthDate 0..1 date Data de nascimento do paciente Slices for deceased[x] 0..1 boolean, dateTime Indica se o paciente é falecido Slice: Unordered, Open by type:$this deceased[x]:deceasedBoolean 0..1 boolean Indicates if the individual is deceased or not deceased[x]:deceasedDateTime 0..1 dateTime Data e hora do falecimento do paciente address 0..* Address Endereço do paciente id 0..1 string Identificador primário deste recurso extension 0..* Extension Extensões adicionais use 0..1 code Uso do endereço type 0..1 code Tipo de endereço text 0..1 string Representação textual do endereço line 0..* string Endereço do paciente city 0..1 string Cidade do endereço district 0..1 string Distrito do endereço state 0..1 string Unidade Federativa postalCode 0..1 string CEP do endereço country 0..1 string País do endereço period 0..1 Period Período de tempo em que o endereço foi usado maritalStatus 0..1 CodeableConcept Estado civil do paciente Slices for multipleBirth[x] 0..1 boolean, integer Indica se o paciente é de parto gemelar Slice: Unordered, Open by type:$this multipleBirth[x]:multipleBirthBoolean 0..1 boolean Whether patient is part of a multiple birth multipleBirth[x]:multipleBirthInteger 0..1 integer Gemelaridade do paciente photo 0..* Attachment Fotografia do paciente contact 0..* BackboneElement Uma pessoa para contato (guardião, companheiro, amigo) em caso de emergência id 0..1 string Identificação unívoca da pessoa de contato extension 0..* Extension Extensões adicionais modifierExtension 0..* Extension Extensões adicionais relationship 0..* CodeableConcept Relação com o paciente name 0..1 HumanName Nome da pessoa de contato telecom 0..* ContactPoint Contatos de telecomunicação da pessoa de contato address 0..1 Address Endereço da pessoa de contato gender 0..1 code Sexo do contato do paciente organization 0..1 Reference(BRCoreOrganization) Organização do contato do paciente period 0..1 Period Período de tempo em que o contato foi usado communication 0..* BackboneElement Idiomas falados pelo paciente id 0..1 string Identificador primário deste recurso extension 0..* Extension Extensões adicionais modifierExtension 0..* Extension Extensões adicionais language 1..1 CodeableConcept Idioma falado pelo paciente preferred 0..1 boolean Indica se o idioma é preferido generalPractitioner 0..* Reference(BRCoreOrganization | BRCorePractitioner | BRCorePractitionerRole) Médico de atenção primária do paciente managingOrganization 0..1 Reference(BRCoreOrganization) Organização responsável pelo paciente link 0..* BackboneElement Links para outros recursos que se relacionam com este recurso id 0..1 string Identificador primário deste recurso extension 0..* Extension Extensões adicionais modifierExtension 0..* Extension Extensões adicionais other 1..1 Reference(BRCorePatient | BRCoreRelatedPerson) Outro recurso que se relaciona com este recurso type 1..1 code Tipo de relação entre os recursos Documentation for this format
Este perfil representa o perfil [br-core-patient](StructureDefinition-br-core-patient.html) com todas as informações demográficas e administrativas necessárias para descrever um paciente no Brasil, com as respectivas legislações dos elementos e domínios obrigatórios conforme abaixo. O perfil [br-core-patient](StructureDefinition-br-core-patient.html) herda do recurso FHIR R4 [Patient](https://hl7.org/fhir/R4B/patient.html) para definições de escopo e uso. Este perfil define expectativas mínimas para o recurso [br-core-patient](StructureDefinition-br-core-patient.html) registrar, pesquisar e buscar dados demográficos básicos e outras informações administrativas sobre um paciente individual. Ele especifica quais elementos principais, extensões, vocabulários e conjuntos de valores DEVEM estar presentes e restringe como os elementos são usados. Para contemplar uma descrição do paciente com maior equidade, conforme recomendações da portaria GM/MS Nº 230, de 7 de março de 2023, foram adicionados atributos adicionais para expressar o sexo do paciente, além do sexo administrativo: sexo ao nascer descritos no ValueSet [BRSexoNascimento](https://terminologia.saude.gov.br/fhir/ValueSet/BRSexoNascimento) e identidade de gênero descrita no ValueSet [BRIdentidadeGenero](https://terminologia.saude.gov.br/fhir/ValueSet/BRIdentidadeGenero). Com relação a orientação sexual, este é um dado que pode mudar durante a vida do paciente, portanto, recomenda-se que ele seja coletado em cada evento assistencial
Information about an individual or animal receiving health care services
Demographics and other administrative information about an individual or animal receiving care or other health-related services.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
Identificação unívoca para o recurso em um sistema
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
URI(s) sob as quais este recurso é conhecido
Um ou mais códigos que servem para identificar o tipo de recurso
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.
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
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).
Texto narrativo, 72 caracteres para resumo
Um texto narrativo resumindo as informações do recurso
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.
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.
Extensões adicionais que não fazem parte do modelo base
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Extensão de populacao tradicional do Core do Brasil
Extensão de povo intinerante do Core do Brasil
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Patients are almost always assigned specific numerical identifiers.
Extensions are always sliced by (at least) url
Extensões incluídas no identificador do paciente
usual: identificador usual do paciente. official: identificador oficial do paciente. temp: identificador temporário do paciente. secondary: identificador secundário do paciente.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
Código que representa o tipo do identificador do paciente
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.
Allows users to make use of identifiers when the identifier system is not known.
Id lógico do tipo do identificador do paciente
Extensões do tipo do identificador do paciente
Extensões incluídas no tipo do identificador do paciente
Codificação do tipo do identificador do paciente
Codificação que representa o tipo do identificador do paciente
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Id lógico da codificação do tipo do identificador do paciente
Extensões da codificação do tipo do identificador do paciente
Extensões incluídas na codificação do tipo do identificador do paciente
Sistema da codificação do tipo do identificador do paciente
Sistema que identifica a codificação do tipo do identificador do paciente
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Versão da codificação do tipo do identificador do paciente
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Código da codificação do tipo do identificador do paciente
Código que representa a codificação do tipo do identificador do paciente
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Texto da codificação do tipo do identificador do paciente
Texto que representa a codificação do tipo do identificador do paciente
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Seleção do usuário da codificação do tipo do identificador do paciente
Indica se a codificação do tipo do identificador do paciente foi selecionada pelo usuário
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Texto do tipo do identificador do paciente
Texto que representa o tipo do identificador do paciente
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Sistema que identifica o tipo do identificador do paciente
Identifier.system is always case sensitive.
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.
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](http://hl7.org/fhir/R4/extension-rendered-value.html). 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.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Período de uso do identificador do paciente
Período de tempo durante o qual o identificador do paciente foi utilizado
Role.effectiveTime or implied by context
Entidade que atribuiu o identificador do paciente
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.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Additional content defined by implementations
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.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Nome da entidade que atribuiu o identificador do paciente
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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.
This resource is generally assumed to be active if no value is provided for the active element
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
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.
Patient.name.given, Patient.name.family, Patient.name.text or Patient.name.extension SHALL be present
(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:family or /f:given or /f:text)) or (not(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:family or /f:given or /f:text))
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Allows the appropriate name for a particular context of use to be selected from among a set of names.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
XPN.7, but often indicated by which field contains the name
Representação textual do nome completo do paciente
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.
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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.
Given Names appear in the correct order for presenting the name
Prefixes appear in the correct order for presenting the name
Suffixes appear in the correct order for presenting the name
Período de tempo em que o nome foi usado
Allows names to be placed in historical context.
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).
People have (primary) ways to contact them in some way such as phone, email.
Sistema de telecomunicação usado para o contato
O sistema de telecomunicação usado para o contato
Telecommunications form for contact point.
O número de telefone ou fax usado para o contato
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.
home | work | temp | old | mobile - propósito do contato
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Indica a ordem de preferência do contato
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Período de tempo em que o contato foi usado
Período em que o meio de contato foi utilizado pelo paciente
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.
Needed for identification of the individual, in combination with (at least) name and birth date.
The gender of a person used for administrative purposes.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
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.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
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.
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.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
Indicates if the individual is deceased or not
Indicates if the individual is deceased or not.
Patient may have multiple addresses with different uses or applicable periods.
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
home | work | temp | old - propósito do endereço
Applications can assume that an address is current unless it explicitly says that it is temporary or old.
Allows an appropriate address to be chosen from a list of many.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
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](http://hl7.org/fhir/R4/location.html#) resource).
The type of an address (physical / postal).
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.
XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
The order in which lines should appear in an address label
XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
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.
ISO 3166 3 letter codes can be used in place of a human readable country name.
Período de tempo em que o endereço foi usado
Allows addresses to be placed in historical context.
The domestic partnership status of a person.
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.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
Whether patient is part of a multiple birth
Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Guidelines: * Use id photos, not clinical photos. * Limit dimensions to thumbnail. * Keep byte count low to ease resource updates.
Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
Uma pessoa para contato (guardião, companheiro, amigo) em caso de emergência
Contact 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.
Need to track people you can contact about the patient.
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()
exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)
player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
Identificação unívoca da pessoa de contato
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Used to determine which contact person is the most relevant to approach, depending on circumstances.
The nature of the relationship between a patient and a contact person for that patient.
Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Contatos de telecomunicação da pessoa de contato
Contact 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.
Need to keep track where the contact person can be contacted per postal mail or visited.
For guardians or business related contacts, the organization is relevant.
A language which may be used to communicate with the patient about his or her health.
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.
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.
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.
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
This language is specifically identified for communicating healthcare information.
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 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.
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).
Need to know who recognizes this patient record, manages and updates it.
Links para outros recursos que se relacionam com este recurso
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.
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'
Outro recurso que se relaciona com este recurso
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.