Legemiddeldata fra institusjon til Legemiddelregisteret — 1.0.7 - ci-build Norway flag

Legemiddeldata fra institusjon til Legemiddelregisteret - Local Development build (v1.0.7) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Pasient - Detailed Descriptions

Draft as of 2025-09-30

Definitions for the lmdi-patient resource profile.

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

0. Patient
2. Patient.text
Control0..0
4. Patient.extension:citizenship
Slice Namecitizenship
Control0..0
6. Patient.identifier
Definition

Identifikator for pasienten. Skal være fødselsnummer (FNR) eller D-nummer (DNR).

ShortIdentifikator for pasienten.
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
8. Patient.identifier:FNR
Slice NameFNR
ShortFødselsnummer
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
Must Supporttrue
10. Patient.identifier:FNR.value
ShortFødselsnummeret (11 siffer)
ExampleFødselsnummer: 12345678901
Fødselsnummer: 13057444850
12. Patient.identifier:FHN
Slice NameFHN
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
14. Patient.identifier:DNR
Slice NameDNR
ShortD-nummer
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
Must Supporttrue
16. Patient.identifier:DNR.value
ShortD-nummer (11 siffer)
ExampleD-nummer: 12345678901
18. Patient.identifier:HNR
Slice NameHNR
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
20. Patient.active
Control0..0
22. Patient.name
Control0..0
24. Patient.telecom
Control0..0
26. Patient.gender
Definition

Pasientens kjønn.

ShortKjønn
Must Supporttrue
28. Patient.birthDate
Definition

Pasientens fødselsdato.

ShortFødselsdato
Must Supporttrue
30. Patient.deceased[x]
Control0..0
32. Patient.address
Must Supporttrue
34. Patient.address.extension:official
Slice Nameofficial
Control0..0
36. Patient.address.extension:urbanDistrict
Slice NameurbanDistrict
Definition

Kodet verdi for bydel. Koder fra kodeverk "Bydelsnummer" (OID 3403) skal benyttes

ShortKodet verdi for bydel. Kodeverk "Bydelsnummer" (OID 3403)
38. Patient.address.extension:propertyInformation
Slice NamepropertyInformation
Control0..0
40. Patient.address.use
Definition

Adressetype begrenset til home, temp eller old

Shorthome | temp | old
BindingThe codes SHALL be taken from LMDI Address Use
(required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-use)

Tillatte verdier er home, temp eller old

Invariantsaddress-use-constraint: Kun home, temp eller old er tillatt for address.use (address.use.empty() or address.use in ('home' | 'temp' | 'old'))
42. Patient.address.type
Shortphysical
BindingThe codes SHALL be taken from LMDI Address Type
(required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-type)
Pattern Valuephysical
44. Patient.address.text
Control0..0
46. Patient.address.line
Control0..0
48. Patient.address.city
Control0..0
50. Patient.address.district
ShortKommune
52. Patient.address.district.extension:municipalitycode
Slice Namemunicipalitycode
Definition

Kodet verdi for kommune. Koder fra kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402) skal benyttes

ShortKodet verdi for kommune. Kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402)
54. Patient.address.state
ShortFylkesnavn
56. Patient.address.postalCode
Control0..0
58. Patient.address.country
Control0..0
60. Patient.maritalStatus
Control0..0
62. Patient.multipleBirth[x]
Control0..0
64. Patient.photo
Control0..0
66. Patient.contact
Control0..0
68. Patient.communication
Control0..0
70. Patient.generalPractitioner
Control0..0
72. Patient.managingOrganization
Control0..0
74. Patient.link
Control0..0

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

0. Patient
Definition

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

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

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

ShortA set of rules under which this content was created
Comments

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

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

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..01
This element is affected by the following invariants: ele-1
TypeNarrative
Is Modifierfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Patient.extension:citizenship
Slice Namecitizenship
Definition

The patient's legal status as citizen of a country.

ShortNation(s) where the patient claims citizenship
Control0..0
This element is affected by the following invariants: ele-1
TypeExtension(Patient Citizenship) (Complex Extension)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Patient.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored
Comments

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

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

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

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

    Identifikator for pasienten. Skal være fødselsnummer (FNR) eller D-nummer (DNR).


    An identifier for this patient.

    ShortIdentifikator for pasienten.An identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

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

      Fødselsnummer for the patient. Fødselsnummer as one of the possible patient identifier, should at least be sent unless there is a reason not to. Reasons for not sending the Fødselsnummer include but are not limited to, research and apps without a contract for processing data.

      Multiple FNR can exist for a person. If several FNR is provided the time period that each identifier is valid should be provided. No information about period is required when only one FNR is provided.


      An identifier for this patient.

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

      Patients are almost always assigned specific numerical identifiers.

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

      The purpose of this identifier.

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

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

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

      Identifies the purpose for this identifier, if known .

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

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

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

      Identifies that this is a Norwegian Fødselsnummer


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

      ShortIdentification of the Norwegian FNRThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

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

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

      Fixed Valueurn:oid:2.16.578.1.12.4.1.4.1
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Patient.identifier:FNR.value
      Definition

      The Norwegian Fødselsnummer


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

      ShortFødselsnummeret (11 siffer)The value that is unique
      Comments

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

      Control10..1
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesFødselsnummer
      ExampleGeneral: 123456
      Fødselsnummer: 13057444850
      Fødselsnummer: 12345678901
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Patient.identifier:FHN
      Slice NameFHN
      Definition

      Felles hjelpenummer for the patient. Felles hjelpenummer as one of the possible patient identification numbers. The norwegian Felles hjelpenummer shoud only be used when the Fødselsnummer og D-number is unknown.


      An identifier for this patient.

      ShortFelles hjelpenummer used for the patientAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      The D-nummer of the patient. (assigned by the norwegian Skatteetaten)


      An identifier for this patient.

      ShortD-nummerAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      The purpose of this identifier.

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

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

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

      Identifies the purpose for this identifier, if known .

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

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

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

      The identification of the Norwegian D-nummer


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

      ShortThe identification of the D-nummerThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

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

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

      Fixed Valueurn:oid:2.16.578.1.12.4.1.4.2
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      41. Patient.identifier:DNR.value
      Definition

      The actual Norwegian D-nummer


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

      ShortD-nummer (11 siffer)The value that is unique
      Comments

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

      Control10..1
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      ExampleGeneral: 123456
      D-nummer: 12345678901
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      43. Patient.identifier:HNR
      Slice NameHNR
      Definition

      A locally assigned H-nummer. If this identifier is used, information about the assigner is mandatory. Merk at lokale hjelpenummer (H-nummer) for pasient ikke garanterer at kombinasjonen system og value er gir unik identifikasjon, siden disse tildeles på lokalt i det enkelte kliniske fagsystem. Felles nasjonale hjelpenummer utstedt av tjenesten for felles hjelpenummer er imidlertid unike i Norge (og globalt unike i kombinasjon med system).


      An identifier for this patient.

      ShortA locally assigned H-nummerAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

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

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

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

      ShortWhether this patient's record is in active use
      Comments

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

      Control0..01
      This element is affected by the following invariants: ele-1
      Typeboolean
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

      Defines the format of norwegian human name according to norwegian legislation (lov om personnavn).


      A name associated with the individual.

      ShortNorwegian human nameA name associated with the patient
      Comments

      Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.


      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeHumanName(no-basis-HumanName)
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

      ShortA contact detail for the individual
      Comments

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

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeContactPoint
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
      55. Patient.gender
      Definition

      Pasientens kjønn.


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

      ShortKjønnmale | female | other | unknown
      Comments

      The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

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

      The gender of a person used for administrative purposes.

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

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

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

      Pasientens fødselsdato.


      The date of birth for the individual.

      ShortFødselsdatoThe date of birth for the individual
      Comments

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

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

      Age of the individual drives many clinical processes.

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

      Indicates if the individual is deceased or not.

      ShortIndicates if the individual is deceased or not
      Comments

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

      Control0..01
      This element is affected by the following invariants: ele-1
      TypeChoice of: boolean, dateTime
      Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

      http://hl7.no/fhir/StructureDefinition/no-basis-Address


      An address for the individual.

      ShortNorwegian addressAn address for the individual
      Comments

      Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).


      Patient may have multiple addresses with different uses or applicable periods.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeAddress(no-basis-Address)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      63. Patient.address.extension:official
      Slice Nameofficial
      Definition

      Defines the concept of an officially registered address in Norway. Usually this will be the adress registered in "Folkeregisteret" for persons or "Enhetsregisteret" for organizations.

      ShortThe concept of an officially registered address
      Control0..0
      This element is affected by the following invariants: ele-1
      TypeExtension(no-basis-address-official) (Extension Type: boolean)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      65. Patient.address.extension:urbanDistrict
      Slice NameurbanDistrict
      Definition

      Kodet verdi for bydel. Koder fra kodeverk "Bydelsnummer" (OID 3403) skal benyttes

      ShortKodet verdi for bydel. Kodeverk "Bydelsnummer" (OID 3403)
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(no-basis-urban-district) (Extension Type: Coding)
      Alternate Namesbydel, urban district
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      67. Patient.address.extension:propertyInformation
      Slice NamepropertyInformation
      Definition

      Additional information identifying norwegian real property.

      Shortreal property identification
      Control0..0
      This element is affected by the following invariants: ele-1
      TypeExtension(no-basis-propertyinformation) (Complex Extension)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      69. Patient.address.use
      Definition

      Adressetype begrenset til home, temp eller old


      The purpose of this address.

      Shorthome | temp | oldhome | work | temp | old | billing - purpose of this address
      Comments

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

      Control0..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from LMDI Address Usehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
      (required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-use)

      Tillatte verdier er home, temp eller old


      The use of an address.

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

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

      ExampleGeneral: home
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      address-use-constraint: Kun home, temp eller old er tillatt for address.use (address.use.empty() or address.use in ('home' | 'temp' | 'old'))
      71. Patient.address.type
      Definition

      Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

      Mapping of values to other Norwegian CodeSystems is documented in the implementation guide. In general the address used for visiting the person should have use "home" and type "physical" or "both". The "official" flag can be either true or false.


      Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

      Shortphysicalpostal | physical | both
      Comments

      The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).


      The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

      Control0..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from LMDI Address Typehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
      (required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-type)
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Pattern Valuephysical
      ExampleGeneral: both
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      73. Patient.address.text
      Definition

      Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

      ShortText representation of the address
      Comments

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

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

      A renderable, unencoded form.

      ExampleGeneral: 137 Nowhere Street, Erewhon 9132
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      75. Patient.address.line
      Definition

      This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

      ShortStreet name, number, direction & P.O. Box etc.
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

      Control0..0*
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      ExampleGeneral: 137 Nowhere Street
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      77. Patient.address.city
      Definition

      When a postalcode is given the name of the city must be according to the official list of postalcodes used in Norway.

      The name of the city, town, village or other community or delivery center.


      The name of the city, town, suburb, village or other community or delivery center.

      ShortPoststed or cityName of city, town etc.
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

      Control0..01
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesMunicpality, by, poststed
      ExampleGeneral: Erewhon
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      79. Patient.address.district
      Definition

      Name of the county (norwegian "kommune").

      The name of the administrative area (county).


      The name of the administrative area (county).

      ShortKommuneDistrict name (aka county)
      Comments

      District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesCounty, kommune
      ExampleGeneral: Madison
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      81. Patient.address.district.extension:municipalitycode
      Slice Namemunicipalitycode
      Definition

      Kodet verdi for kommune. Koder fra kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402) skal benyttes

      ShortKodet verdi for kommune. Kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402)
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(no-basis-municipalitycode) (Extension Type: Coding)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      83. Patient.address.state
      Definition

      Name of the norwegian "fylke"). If fylkes-number is required "eiendomsinformasjon" should be used with koded kommune-number.

      Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes).


      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).

      ShortFylkesnavnSub-unit of country (abbreviations ok)
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

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

      A postal code designating a region defined by the postal service.

      In Norway this is af four digit number defined by the norwegian postal service.


      A postal code designating a region defined by the postal service.

      ShortPostal code for area
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

      Control0..01
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesZip, postnummer
      ExampleGeneral: 9132
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      87. Patient.address.country
      Definition

      Country - a nation as commonly understood or generally accepted.

      ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
      Comments

      ISO 3166 3 letter codes can be used in place of a human readable country name.

      Control0..01
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      89. Patient.maritalStatus
      Definition

      This field contains a patient's most recent marital (civil) status.

      ShortMarital (civil) status of a patient
      Comments

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

      Control0..01
      This element is affected by the following invariants: ele-1
      BindingUnless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status|4.0.1
      (extensible to http://hl7.org/fhir/ValueSet/marital-status)

      The domestic partnership status of a person.

      TypeCodeableConcept
      Is Modifierfalse
      Requirements

      Most, if not all systems capture it.

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

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

      ShortWhether patient is part of a multiple birth
      Comments

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

      Control0..01
      This element is affected by the following invariants: ele-1
      TypeChoice of: boolean, integer
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Requirements

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

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

      Image of the patient.

      ShortImage of the patient
      Comments

      Guidelines:

      • Use id photos, not clinical photos.
      • Limit dimensions to thumbnail.
      • Keep byte count low to ease resource updates.
      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeAttachment
      Is Modifierfalse
      Requirements

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

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

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

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

      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.

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifierfalse
      Requirements

      Need to track people you can contact about the patient.

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

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

      ShortA language which may be used to communicate with the patient about his or her health
      Comments

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

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifierfalse
      Requirements

      If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

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

      Patient's nominated care provider.

      ShortPatient's nominated primary care provider
      Comments

      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.

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeReference(Organization, Practitioner, PractitionerRole, no-basis-Practitioner, no-basis-PractitionerRole, no-basis-Organization, Organization, Practitioner, PractitionerRole)
      Is Modifierfalse
      Alternate NamescareProvider
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
      105. Patient.managingOrganization
      Definition

      Organization that is the custodian of the patient record.

      ShortOrganization that is the custodian of the patient record
      Comments

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

      Control0..01
      This element is affected by the following invariants: ele-1
      TypeReference(Organization, no-basis-Organization, Organization)
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

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

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

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

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
      Summarytrue
      Requirements

      There are multiple use cases:

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

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

      0. Patient
      Definition

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

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

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

      ShortLogical id of this artifact
      Comments

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

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

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

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

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

      ShortA set of rules under which this content was created
      Comments

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

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

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

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

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

      A human language.

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

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

      ShortText summary of the resource, for human interpretation
      Comments

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

      Control0..0
      This element is affected by the following invariants: ele-1
      TypeNarrative
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Patient.contained
      Definition

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

      ShortContained, inline Resources
      Comments

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

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

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

      ShortAdditional content defined by implementations
      Comments

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

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

        The patient's legal status as citizen of a country.

        ShortNation(s) where the patient claims citizenship
        Control0..0
        This element is affected by the following invariants: ele-1
        TypeExtension(Patient Citizenship) (Complex Extension)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. Patient.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

          Identifikator for pasienten. Skal være fødselsnummer (FNR) eller D-nummer (DNR).

          ShortIdentifikator for pasienten.
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Must Supporttrue
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

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

            Fødselsnummer for the patient. Fødselsnummer as one of the possible patient identifier, should at least be sent unless there is a reason not to. Reasons for not sending the Fødselsnummer include but are not limited to, research and apps without a contract for processing data.

            Multiple FNR can exist for a person. If several FNR is provided the time period that each identifier is valid should be provided. No information about period is required when only one FNR is provided.

            ShortFødselsnummer
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeIdentifier
            Must Supporttrue
            Summarytrue
            Requirements

            Patients are almost always assigned specific numerical identifiers.

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

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

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

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

            ShortAdditional content defined by implementations
            Comments

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

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

              The purpose of this identifier.

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

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

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

              Identifies the purpose for this identifier, if known .

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

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

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

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

              ShortDescription of identifier
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

              TypeCodeableConcept
              Summarytrue
              Requirements

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

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

              Identifies that this is a Norwegian Fødselsnummer

              ShortIdentification of the Norwegian FNR
              Comments

              Identifier.system is always case sensitive.

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

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

              Fixed Valueurn:oid:2.16.578.1.12.4.1.4.1
              ExampleGeneral: http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Patient.identifier:FNR.value
              Definition

              The Norwegian Fødselsnummer

              ShortFødselsnummeret (11 siffer)
              Comments

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

              Control1..1
              This element is affected by the following invariants: ele-1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Alternate NamesFødselsnummer
              ExampleGeneral: 123456
              Fødselsnummer: 13057444850
              Fødselsnummer: 12345678901
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Patient.identifier:FNR.period
              Definition

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

              ShortTime period when id is/was valid for use
              Comments

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

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

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

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeReference(Organization)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
              54. Patient.identifier:FHN
              Slice NameFHN
              Definition

              Felles hjelpenummer for the patient. Felles hjelpenummer as one of the possible patient identification numbers. The norwegian Felles hjelpenummer shoud only be used when the Fødselsnummer og D-number is unknown.

              ShortFelles hjelpenummer used for the patient
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..0
              This element is affected by the following invariants: ele-1
              TypeIdentifier
              Summarytrue
              Requirements

              Patients are almost always assigned specific numerical identifiers.

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

              The D-nummer of the patient. (assigned by the norwegian Skatteetaten)

              ShortD-nummer
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeIdentifier
              Must Supporttrue
              Summarytrue
              Requirements

              Patients are almost always assigned specific numerical identifiers.

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

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

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

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

              ShortAdditional content defined by implementations
              Comments

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

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

                The purpose of this identifier.

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

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

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

                Identifies the purpose for this identifier, if known .

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

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

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

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

                ShortDescription of identifier
                Comments

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

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                TypeCodeableConcept
                Summarytrue
                Requirements

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

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

                The identification of the Norwegian D-nummer

                ShortThe identification of the D-nummer
                Comments

                Identifier.system is always case sensitive.

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

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

                Fixed Valueurn:oid:2.16.578.1.12.4.1.4.2
                ExampleGeneral: http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. Patient.identifier:DNR.value
                Definition

                The actual Norwegian D-nummer

                ShortD-nummer (11 siffer)
                Comments

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

                Control1..1
                This element is affected by the following invariants: ele-1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                ExampleGeneral: 123456
                D-nummer: 12345678901
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Patient.identifier:DNR.period
                Definition

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

                ShortTime period when id is/was valid for use
                Comments

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

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

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

                Organization that issued/manages the identifier.

                ShortOrganization that issued id (may be just text)
                Comments

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

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeReference(Organization)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                82. Patient.identifier:HNR
                Slice NameHNR
                Definition

                A locally assigned H-nummer. If this identifier is used, information about the assigner is mandatory. Merk at lokale hjelpenummer (H-nummer) for pasient ikke garanterer at kombinasjonen system og value er gir unik identifikasjon, siden disse tildeles på lokalt i det enkelte kliniske fagsystem. Felles nasjonale hjelpenummer utstedt av tjenesten for felles hjelpenummer er imidlertid unike i Norge (og globalt unike i kombinasjon med system).

                ShortA locally assigned H-nummer
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..0
                This element is affected by the following invariants: ele-1
                TypeIdentifier
                Summarytrue
                Requirements

                Patients are almost always assigned specific numerical identifiers.

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

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

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

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

                ShortWhether this patient's record is in active use
                Comments

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

                Control0..0
                This element is affected by the following invariants: ele-1
                Typeboolean
                Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

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

                Defines the format of norwegian human name according to norwegian legislation (lov om personnavn).

                ShortNorwegian human name
                Comments

                Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeHumanName(no-basis-HumanName)
                Summarytrue
                Requirements

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

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

                A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

                ShortA contact detail for the individual
                Comments

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

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeContactPoint
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                109. Patient.gender
                Definition

                Pasientens kjønn.

                ShortKjønn
                Comments

                The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

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

                The gender of a person used for administrative purposes.

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

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

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

                Pasientens fødselsdato.

                ShortFødselsdato
                Comments

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

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

                Age of the individual drives many clinical processes.

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

                Indicates if the individual is deceased or not.

                ShortIndicates if the individual is deceased or not
                Comments

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

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeChoice of: boolean, dateTime
                Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

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

                http://hl7.no/fhir/StructureDefinition/no-basis-Address

                ShortNorwegian address
                Comments

                Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeAddress(no-basis-Address)
                Must Supporttrue
                Summarytrue
                Requirements

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

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

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

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

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

                ShortAdditional content defined by implementations
                Comments

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

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

                  Defines the concept of an officially registered address in Norway. Usually this will be the adress registered in "Folkeregisteret" for persons or "Enhetsregisteret" for organizations.

                  ShortThe concept of an officially registered address
                  Control0..0
                  This element is affected by the following invariants: ele-1
                  TypeExtension(no-basis-address-official) (Extension Type: boolean)
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  123. Patient.address.extension:urbanDistrict
                  Slice NameurbanDistrict
                  Definition

                  Kodet verdi for bydel. Koder fra kodeverk "Bydelsnummer" (OID 3403) skal benyttes

                  ShortKodet verdi for bydel. Kodeverk "Bydelsnummer" (OID 3403)
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(no-basis-urban-district) (Extension Type: Coding)
                  Alternate Namesbydel, urban district
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  125. Patient.address.extension:propertyInformation
                  Slice NamepropertyInformation
                  Definition

                  Additional information identifying norwegian real property.

                  Shortreal property identification
                  Control0..0
                  This element is affected by the following invariants: ele-1
                  TypeExtension(no-basis-propertyinformation) (Complex Extension)
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  127. Patient.address.use
                  Definition

                  Adressetype begrenset til home, temp eller old

                  Shorthome | temp | old
                  Comments

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

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from LMDI Address Use
                  (required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-use)

                  Tillatte verdier er home, temp eller old

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

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

                  ExampleGeneral: home
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  address-use-constraint: Kun home, temp eller old er tillatt for address.use (address.use.empty() or address.use in ('home' | 'temp' | 'old'))
                  129. Patient.address.type
                  Definition

                  Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

                  Mapping of values to other Norwegian CodeSystems is documented in the implementation guide. In general the address used for visiting the person should have use "home" and type "physical" or "both". The "official" flag can be either true or false.

                  Shortphysical
                  Comments

                  The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from LMDI Address Type
                  (required to http://hl7.no/fhir/ig/lmdi/ValueSet/lmdi-address-type)
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Pattern Valuephysical
                  ExampleGeneral: both
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  131. Patient.address.text
                  Definition

                  Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                  ShortText representation of the address
                  Comments

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

                  Control0..0
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  A renderable, unencoded form.

                  ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  133. Patient.address.line
                  Definition

                  This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                  ShortStreet name, number, direction & P.O. Box etc.
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..0
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  ExampleGeneral: 137 Nowhere Street
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  135. Patient.address.city
                  Definition

                  When a postalcode is given the name of the city must be according to the official list of postalcodes used in Norway.

                  The name of the city, town, village or other community or delivery center.

                  ShortPoststed or city
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..0
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Alternate NamesMunicpality, by, poststed
                  ExampleGeneral: Erewhon
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  137. Patient.address.district
                  Definition

                  Name of the county (norwegian "kommune").

                  The name of the administrative area (county).

                  ShortKommune
                  Comments

                  District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

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

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

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

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    Kodet verdi for kommune. Koder fra kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402) skal benyttes

                    ShortKodet verdi for kommune. Kodeverk "Kommunenummer og regionale spesialkoder" (OID 3402)
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(no-basis-municipalitycode) (Extension Type: Coding)
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    145. Patient.address.district.value
                    Definition

                    Primitive value for string

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

                    Name of the norwegian "fylke"). If fylkes-number is required "eiendomsinformasjon" should be used with koded kommune-number.

                    Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes).

                    ShortFylkesnavn
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

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

                    A postal code designating a region defined by the postal service.

                    In Norway this is af four digit number defined by the norwegian postal service.

                    ShortPostal code for area
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Alternate NamesZip, postnummer
                    ExampleGeneral: 9132
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    151. Patient.address.country
                    Definition

                    Country - a nation as commonly understood or generally accepted.

                    ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                    Comments

                    ISO 3166 3 letter codes can be used in place of a human readable country name.

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    153. Patient.address.period
                    Definition

                    Time period when address was/is in use.

                    ShortTime period when address was/is in use
                    Comments

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

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

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

                    Allows addresses to be placed in historical context.

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

                    This field contains a patient's most recent marital (civil) status.

                    ShortMarital (civil) status of a patient
                    Comments

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

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                    (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                    The domestic partnership status of a person.

                    TypeCodeableConcept
                    Requirements

                    Most, if not all systems capture it.

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

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

                    ShortWhether patient is part of a multiple birth
                    Comments

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

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeChoice of: boolean, integer
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Requirements

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

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

                    Image of the patient.

                    ShortImage of the patient
                    Comments

                    Guidelines:

                    • Use id photos, not clinical photos.
                    • Limit dimensions to thumbnail.
                    • Keep byte count low to ease resource updates.
                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeAttachment
                    Requirements

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

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

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

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

                    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.

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Requirements

                    Need to track people you can contact about the patient.

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

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

                    ShortA language which may be used to communicate with the patient about his or her health
                    Comments

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

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Requirements

                    If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

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

                    Patient's nominated care provider.

                    ShortPatient's nominated primary care provider
                    Comments

                    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.

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeReference(Organization, Practitioner, PractitionerRole, no-basis-Practitioner, no-basis-PractitionerRole, no-basis-Organization)
                    Alternate NamescareProvider
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                    182. Patient.managingOrganization
                    Definition

                    Organization that is the custodian of the patient record.

                    ShortOrganization that is the custodian of the patient record
                    Comments

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

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeReference(Organization, no-basis-Organization)
                    Summarytrue
                    Requirements

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

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

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

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

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

                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                    Summarytrue
                    Requirements

                    There are multiple use cases:

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