HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1

HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1 - Local Development build (v0.9.1). See the Directory of published versions

Patient


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="obf-Patient"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>Patient Profile</b></p>
  <p>A person in the role of a patient. Sometimes, the patient is not the subject of information in a clinical statement where the Patient is the SubjectOfRecord.

Compatibility: Lies at the intersection of Argonaut and US Core Patient. MaritalStatus has a required binding in Argonaut, but an extensible binding in US-Core. To be feasible under both DSTU2 Argonaut and STU3 US-Core, the required binding strength is adopted.</p>
  <p><b>Mapping Summary</b></p>
  <p><pre>obf.Patient maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient:
  Language maps to language
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.SourceSystem maps to meta.source
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Narrative maps to text
  Identifier maps to identifier
  Active maps to active
  HumanName maps to name
  ContactPoint maps to telecom
  AdministrativeGender maps to gender
  BirthDate maps to birthDate
  Deceased maps to deceased[x]
  Address maps to address
  MaritalStatus maps to maritalStatus
  MultipleBirth maps to multipleBirth[x]
  PhotographicImage maps to photo
  ContactPerson.Relationship maps to contact.relationship
  ContactPerson.HumanName maps to contact.name
  ContactPerson.ContactPoint maps to contact.telecom
  ContactPerson.Address maps to contact.address
  ContactPerson.AdministrativeGender maps to contact.gender
  ContactPerson.Organization maps to contact.organization
  ContactPerson.TimePeriod maps to contact.period
  Communication.Language maps to communication.language
  Communication.Preferred maps to communication.preferred
  GeneralPractitioner maps to generalPractitioner
  ManagingOrganization maps to managingOrganization
  SamePersonAs.Patient maps to link.other
  SamePersonAs.Relationship maps to link.type
  BirthSex maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex
  Race maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
  Ethnicity maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
</pre></p>
</div>
  </text>
  <url value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
  <version value="0.9.1"/>
  <name value="Patient"/>
  <title value="obf-Patient"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2019-08-01T00:00:00-04:00"/>
  <publisher value="HL7 International Clinical Interoperability Council"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic"/>
    </telecom>
  </contact>
  <description
               value="A person in the role of a patient. Sometimes, the patient is not the subject of information in a clinical statement where the Patient is the SubjectOfRecord.

Compatibility: Lies at the intersection of Argonaut and US Core Patient. MaritalStatus has a required binding in Argonaut, but an extensible binding in US-Core. To be feasible under both DSTU2 Argonaut and STU3 US-Core, the required binding strength is adopted."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.0"/>
  <mapping>
    <identity value="argonaut-dq-dstu2"/>
    <uri value="http://unknown.org/Argonaut-DQ-DSTU2"/>
    <name value="Argonaut-DQ-DSTU2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="cda"/>
    <uri value="http://hl7.org/v3/cda"/>
    <name value="CDA (R2)"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="loinc"/>
    <uri value="http://loinc.org"/>
    <name value="LOINC code for the element"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Patient"/>
  <baseDefinition
                  value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Patient">
      <path value="Patient"/>
      <short value="obf-Patient"/>
      <definition
                  value="A person in the role of a patient. Sometimes, the patient is not the subject of information in a clinical statement where the Patient is the SubjectOfRecord.

Compatibility: Lies at the intersection of Argonaut and US Core Patient. MaritalStatus has a required binding in Argonaut, but an extensible binding in US-Core. To be feasible under both DSTU2 Argonaut and STU3 US-Core, the required binding strength is adopted."/>
      <alias value="SubjectOfCare Client Resident"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="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"/>
        <expression
                    value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human value="A resource should have narrative for robust management"/>
        <expression value="text.div.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="DomainResource"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Patient[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument.recordTarget.patientRole"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient"/>
      </mapping>
    </element>
    <element id="Patient.id">
      <path value="Patient.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Patient.meta">
      <path value="Patient.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Patient.implicitRules">
      <path value="Patient.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="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."/>
      <comment
               value="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&#39;s narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="Patient.language">
      <path value="Patient.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="Patient.text">
      <path value="Patient.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Patient.contained">
      <path value="Patient.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.extension">
      <path value="Patient.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Patient.extension:race">
      <path value="Patient.extension"/>
      <sliceName value="race"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:ethnicity">
      <path value="Patient.extension"/>
      <sliceName value="ethnicity"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:birthsex">
      <path value="Patient.extension"/>
      <sliceName value="birthsex"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.modifierExtension">
      <path value="Patient.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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&#39;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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.identifier">
      <path value="Patient.identifier"/>
      <short value="An identifier for this patient"/>
      <definition value="An identifier for this patient."/>
      <requirements
                    value="Patients are almost always assigned specific numerical identifiers."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Patient.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier"/>
      </mapping>
    </element>
    <element id="Patient.identifier.id">
      <path value="Patient.identifier.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.identifier.extension">
      <path value="Patient.identifier.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.identifier.use">
      <path value="Patient.identifier.use"/>
      <short value="usual | official | temp | secondary | old (If known)"/>
      <definition value="The purpose of this identifier."/>
      <comment
               value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/>
      <requirements
                    value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one."/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Identifies the purpose for this identifier, if known ."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="Patient.identifier.type">
      <path value="Patient.identifier.type"/>
      <short value="Description of identifier"/>
      <definition
                  value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/>
      <comment
               value="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."/>
      <requirements
                    value="Allows users to make use of identifiers when the identifier system is not known."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="CX.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="Patient.identifier.system">
      <path value="Patient.identifier.system"/>
      <short value="The namespace for the identifier value"/>
      <definition
                  value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/>
      <comment value="Identifier.system is always case sensitive."/>
      <requirements
                    value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / EI-2-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="II.root or Role.id.root"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierType"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.system"/>
      </mapping>
    </element>
    <element id="Patient.identifier.value">
      <path value="Patient.identifier.value"/>
      <short value="The value that is unique within the system."/>
      <definition
                  value="The portion of the identifier typically relevant to the user and which is unique within the context of the system."/>
      <comment
               value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;s primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.value"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.1 / EI.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Value"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.value"/>
      </mapping>
    </element>
    <element id="Patient.identifier.period">
      <path value="Patient.identifier.period"/>
      <short value="Time period when id is/was valid for use"/>
      <definition
                  value="Time period during which identifier is/was valid for use."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.7 + CX.8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.effectiveTime or implied by context"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.identifier.assigner">
      <path value="Patient.identifier.assigner"/>
      <short value="Organization that issued id (may be just text)"/>
      <definition value="Organization that issued/manages the identifier."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.assigner"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / (CX.4,CX.9,CX.10)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierIssuingAuthority"/>
      </mapping>
    </element>
    <element id="Patient.active">
      <path value="Patient.active"/>
      <short value="Whether this patient&#39;s record is in active use"/>
      <definition
                  value="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&#39;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."/>
      <comment
               value="If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient."/>
      <requirements
                    value="Need to be able to mark a patient record as not to be used because it was created in error."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.active"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <meaningWhenMissing
                          value="This resource is generally assumed to be active if no value is provided for the active element"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="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"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="statusCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.name">
      <path value="Patient.name"/>
      <short value="A name associated with the patient"/>
      <definition value="A name associated with the individual."/>
      <comment
               value="A patient may have multiple names with different uses or applicable periods. For animals, the name is a &quot;HumanName&quot; in the sense that is assigned and used by humans and has the same patterns."/>
      <requirements
                    value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Patient.name"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <constraint>
        <key value="us-core-8"/>
        <severity value="error"/>
        <human
               value="Patient.name.given  or Patient.name.family or both SHALL be present"/>
        <expression value="family.exists() or given.exists()"/>
        <xpath value="f:given or f:family"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-5, PID-9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="name"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.name"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name"/>
      </mapping>
    </element>
    <element id="Patient.name.id">
      <path value="Patient.name.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.name.extension">
      <path value="Patient.name.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.name.use">
      <path value="Patient.name.use"/>
      <short
             value="usual | official | temp | nickname | anonymous | old | maiden"/>
      <definition value="Identifies the purpose for this name."/>
      <comment
               value="Applications can assume that a name is current unless it explicitly says that it is temporary or old."/>
      <requirements
                    value="Allows the appropriate name for a particular context of use to be selected from among a set of names."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old name etc.for a current/permanent one"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="NameUse"/>
        </extension>
        <strength value="required"/>
        <description value="The use of a human name."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/name-use|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.7, but often indicated by which field contains the name"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unique(./use)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./NamePurpose"/>
      </mapping>
    </element>
    <element id="Patient.name.text">
      <path value="Patient.name.text"/>
      <short value="Text representation of the full name"/>
      <definition
                  value="Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts."/>
      <comment
               value="Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present,  no content is included in the text that isn&#39;t found in a part."/>
      <requirements value="A renderable, unencoded form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="implied by XPN.11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./formatted"/>
      </mapping>
    </element>
    <element id="Patient.name.family">
      <path value="Patient.name.family"/>
      <short value="Family name (often called &#39;Surname&#39;)"/>
      <definition
                  value="The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father."/>
      <comment
               value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)."/>
      <alias value="surname"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.family"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.1/FN.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = FAM]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./FamilyName"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.family"/>
      </mapping>
    </element>
    <element id="Patient.name.given">
      <path value="Patient.name.given"/>
      <short
             value="Given names (not always &#39;first&#39;). Includes middle names"/>
      <definition value="Given name."/>
      <comment
               value="If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren&#39;t due to paractical limitations.  This element is not called &quot;first name&quot; since given names do not always come first."/>
      <alias value="first name"/>
      <alias value="middle name"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="HumanName.given"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Given Names appear in the correct order for presenting the name"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.2 + XPN.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = GIV]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./GivenNames"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.given"/>
      </mapping>
    </element>
    <element id="Patient.name.prefix">
      <path value="Patient.name.prefix"/>
      <short value="Parts that come before the name"/>
      <definition
                  value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="HumanName.prefix"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Prefixes appear in the correct order for presenting the name"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = PFX]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./TitleCode"/>
      </mapping>
    </element>
    <element id="Patient.name.suffix">
      <path value="Patient.name.suffix"/>
      <short value="Parts that come after the name"/>
      <definition
                  value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="HumanName.suffix"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Suffixes appear in the correct order for presenting the name"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN/4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = SFX]"/>
      </mapping>
    </element>
    <element id="Patient.name.period">
      <path value="Patient.name.period"/>
      <short value="Time period when name was/is in use"/>
      <definition
                  value="Indicates the period of time when this name was valid for the named person."/>
      <requirements value="Allows names to be placed in historical context."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.13 + XPN.14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.telecom">
      <path value="Patient.telecom"/>
      <short value="A contact detail for the individual"/>
      <definition
                  value="A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted."/>
      <comment
               value="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&#39;s phone)."/>
      <requirements
                    value="People have (primary) ways to contact them in some way such as phone, email."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.telecom"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactPoint"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-13, PID-14, PID-40"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="telecom"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".telecom"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.telecom.id">
      <path value="Patient.telecom.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.telecom.extension">
      <path value="Patient.telecom.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.telecom.system">
      <path value="Patient.telecom.system"/>
      <short value="phone | fax | email | pager | url | sms | other"/>
      <definition
                  value="Telecommunications form for contact point - what communications system is required to make use of the contact."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ContactPoint.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <condition value="cpt-2"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="Telecommunications form for contact point."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/contact-point-system"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XTN.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./scheme"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./ContactPointType"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.telecom.value">
      <path value="Patient.telecom.value"/>
      <short value="The actual contact point details"/>
      <definition
                  value="The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address)."/>
      <comment
               value="Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value."/>
      <requirements
                    value="Need to support legacy numbers that are not in a tightly controlled format."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ContactPoint.value"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XTN.1 (or XTN.12)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./url"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Value"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.telecom.use">
      <path value="Patient.telecom.use"/>
      <short
             value="home | work | temp | old | mobile - purpose of this contact point"/>
      <definition value="Identifies the purpose for the contact point."/>
      <comment
               value="Applications can assume that a contact is current unless it explicitly says that it is temporary or old."/>
      <requirements
                    value="Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ContactPoint.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old contact etc.for a current/permanent one"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ContactPointUse"/>
        </extension>
        <strength value="required"/>
        <description value="Use of contact point."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/contact-point-use|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XTN.2 - but often indicated by field"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unique(./use)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./ContactPointPurpose"/>
      </mapping>
    </element>
    <element id="Patient.telecom.rank">
      <path value="Patient.telecom.rank"/>
      <short value="Specify preferred order of use (1 = highest)"/>
      <definition
                  value="Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values."/>
      <comment
               value="Note that rank does not necessarily follow the order in which the contacts are represented in the instance."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ContactPoint.rank"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.telecom.period">
      <path value="Patient.telecom.period"/>
      <short value="Time period when the contact point was/is in use"/>
      <definition value="Time period when the contact point was/is in use."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ContactPoint.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.gender">
      <path value="Patient.gender"/>
      <short value="male | female | other | unknown"/>
      <definition
                  value="Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes."/>
      <comment
               value="The gender might not match the biological sex as determined by genetics or the individual&#39;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 &quot;hard&quot; error.  See the Patient Gender and Sex section for additional information about communicating patient gender and sex."/>
      <requirements
                    value="Needed for identification of the individual, in combination with (at least) name and birth date."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.gender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.administrativeGenderCode"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.birthDate">
      <path value="Patient.birthDate"/>
      <short value="The date of birth for the individual"/>
      <definition value="The date of birth for the individual."/>
      <comment
               value="At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension &quot;patient-birthTime&quot; available that should be used where Time is required (such as in maternity/infant care systems)."/>
      <requirements
                    value="Age of the individual drives many clinical processes."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.birthDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.birthTime"/>
      </mapping>
      <mapping>
        <identity value="loinc"/>
        <map value="21112-8"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.deceased[x]">
      <path value="Patient.deceased[x]"/>
      <short value="Indicates if the individual is deceased or not"/>
      <definition value="Indicates if the individual is deceased or not."/>
      <comment
               value="If there&#39;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."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.deceased[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="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."/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-30  (bool) and PID-29 (datetime)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.address">
      <path value="Patient.address"/>
      <short value="An address for the individual"/>
      <definition value="An address for the individual."/>
      <comment
               value="Patient may have multiple addresses with different uses or applicable periods."/>
      <requirements
                    value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.address"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Address"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="addr"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".addr"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.address.id">
      <path value="Patient.address.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.address.extension">
      <path value="Patient.address.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.address.use">
      <path value="Patient.address.use"/>
      <short
             value="home | work | temp | old | billing - purpose of this address"/>
      <definition value="The purpose of this address."/>
      <comment
               value="Applications can assume that an address is current unless it explicitly says that it is temporary or old."/>
      <requirements
                    value="Allows an appropriate address to be chosen from a list of many."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old address etc.for a current/permanent one"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AddressUse"/>
        </extension>
        <strength value="required"/>
        <description value="The use of an address."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/address-use|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unique(./use)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./AddressPurpose"/>
      </mapping>
    </element>
    <element id="Patient.address.type">
      <path value="Patient.address.type"/>
      <short value="postal | physical | both"/>
      <definition
                  value="Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both."/>
      <comment
               value="The definition of Address states that &quot;address is intended to describe postal addresses, not physical locations&quot;. However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the [Location](http://hl7.org/fhir/R4/location.html#) resource)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AddressType"/>
        </extension>
        <strength value="required"/>
        <description value="The type of an address (physical / postal)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/address-type|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.18"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unique(./use)"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="address type parameter"/>
      </mapping>
    </element>
    <element id="Patient.address.text">
      <path value="Patient.address.text"/>
      <short value="Text representation of the address"/>
      <definition
                  value="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."/>
      <comment
               value="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&#39;t found in a part."/>
      <requirements value="A renderable, unencoded form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./formatted"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="address label parameter"/>
      </mapping>
    </element>
    <element id="Patient.address.line">
      <path value="Patient.address.line"/>
      <short value="Street name, number, direction &amp; P.O. Box etc."/>
      <definition
                  value="This component contains the house number, apartment number, street name, street direction,  P.O. Box number, delivery hints, and similar address information."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Address.line"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="The order in which lines should appear in an address label"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = AL]"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="street"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StreetAddress (newline delimitted)"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.address.city">
      <path value="Patient.address.city"/>
      <short value="Name of city, town etc."/>
      <definition
                  value="The name of the city, town, suburb, village or other community or delivery center."/>
      <alias value="Municpality"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.city"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = CTY]"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="locality"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Jurisdiction"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.address.district">
      <path value="Patient.address.district"/>
      <short value="District name (aka county)"/>
      <definition value="The name of the administrative area (county)."/>
      <comment
               value="District is sometimes known as county, but in some regions &#39;county&#39; is used in place of city (municipality), so county name should be conveyed in city instead."/>
      <alias value="County"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.district"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = CNT | CPA]"/>
      </mapping>
    </element>
    <element id="Patient.address.state">
      <path value="Patient.address.state"/>
      <short value="Sub-unit of country (abbreviations ok)"/>
      <definition
                  value="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)."/>
      <alias value="Province"/>
      <alias value="Territory"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.state"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description value="Two Letter USPS alphabetic codes."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = STA]"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="region"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Region"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.address.postalCode">
      <path value="Patient.address.postalCode"/>
      <short value="US Zip Codes"/>
      <definition
                  value="A postal code designating a region defined by the postal service."/>
      <alias value="Zip"/>
      <alias value="Zip Code"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.postalCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = ZIP]"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./PostalIdentificationCode"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.address.country">
      <path value="Patient.address.country"/>
      <short value="Country (e.g. can be ISO 3166 2 or 3 letter code)"/>
      <definition
                  value="Country - a nation as commonly understood or generally accepted."/>
      <comment
               value="ISO 3166 3 letter codes can be used in place of a human readable country name."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.country"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="AD.part[parttype = CNT]"/>
      </mapping>
      <mapping>
        <identity value="vcard"/>
        <map value="country"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Country"/>
      </mapping>
    </element>
    <element id="Patient.address.period">
      <path value="Patient.address.period"/>
      <short value="Time period when address was/is in use"/>
      <definition value="Time period when address was/is in use."/>
      <requirements value="Allows addresses to be placed in historical context."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Address.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XAD.12 / XAD.13 + XAD.14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.maritalStatus">
      <path value="Patient.maritalStatus"/>
      <short value="Marital (civil) status of a patient"/>
      <definition
                  value="This field contains a patient&#39;s most recent marital (civil) status."/>
      <requirements value="Most, if not all systems capture it."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.maritalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MaritalStatus"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="required"/>
        <description value="The domestic partnership status of a person."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/marital-status"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="player[classCode=PSN]/maritalStatusCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.maritalStatusCode"/>
      </mapping>
    </element>
    <element id="Patient.multipleBirth[x]">
      <path value="Patient.multipleBirth[x]"/>
      <short value="Whether patient is part of a multiple birth"/>
      <definition
                  value="Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer)."/>
      <comment
               value="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)."/>
      <requirements
                    value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn&#39;t meet the patient, such as labs."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.multipleBirth[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-24 (bool), PID-25 (integer)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.photo">
      <path value="Patient.photo"/>
      <short value="Image of the patient"/>
      <definition value="Image of the patient."/>
      <comment
               value="Guidelines:
* Use id photos, not clinical photos.
* Limit dimensions to thumbnail.
* Keep byte count low to ease resource updates."/>
      <requirements
                    value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.photo"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-5 - needs a profile"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Contact"/>
      </extension>
      <path value="Patient.contact"/>
      <short
             value="A contact party (e.g. guardian, partner, friend) for the patient"/>
      <definition
                  value="A contact party (e.g. guardian, partner, friend) for the patient."/>
      <comment
               value="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."/>
      <requirements
                    value="Need to track people you can contact about the patient."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="pat-1"/>
        <severity value="error"/>
        <human
               value="SHALL at least contain a contact&#39;s details or a reference to an organization"/>
        <expression
                    value="name.exists() or telecom.exists() or address.exists() or organization.exists()"/>
        <xpath
               value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.id">
      <path value="Patient.contact.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.extension">
      <path value="Patient.contact.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.modifierExtension">
      <path value="Patient.contact.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.contact.relationship">
      <path value="Patient.contact.relationship"/>
      <short value="The kind of relationship"/>
      <definition
                  value="The nature of the relationship between the patient and the contact person."/>
      <requirements
                    value="Used to determine which contact person is the most relevant to approach, depending on circumstances."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact.relationship"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ContactRelationship"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="The nature of the relationship between a patient and a contact person for that patient."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/patient-contactrelationship"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-7, NK1-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.name">
      <path value="Patient.contact.name"/>
      <short value="A name associated with the contact person"/>
      <definition value="A name associated with the contact person."/>
      <requirements
                    value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="name"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.telecom">
      <path value="Patient.contact.telecom"/>
      <short value="A contact detail for the person"/>
      <definition
                  value="A contact detail for the person, e.g. a telephone number or an email address."/>
      <comment
               value="Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification."/>
      <requirements
                    value="People have (primary) ways to contact them in some way such as phone, email."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact.telecom"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactPoint"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-5, NK1-6, NK1-40"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="telecom"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.address">
      <path value="Patient.contact.address"/>
      <short value="Address for the contact person"/>
      <definition value="Address for the contact person."/>
      <requirements
                    value="Need to keep track where the contact person can be contacted per postal mail or visited."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.address"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Address"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="addr"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.gender">
      <path value="Patient.contact.gender"/>
      <short value="male | female | other | unknown"/>
      <definition
                  value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes."/>
      <requirements value="Needed to address the person correctly."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.gender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdministrativeGender"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The gender of a person used for administrative purposes."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.0"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-15"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.organization">
      <path value="Patient.contact.organization"/>
      <short value="Organization that is associated with the contact"/>
      <definition
                  value="Organization on behalf of which the contact is acting or for which the contact is working."/>
      <requirements
                    value="For guardians or business related contacts, the organization is relevant."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.organization"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
      <condition value="pat-1"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="scoper"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.period">
      <path value="Patient.contact.period"/>
      <short
             value="The period during which this contact person or organization is valid to be contacted relating to this patient"/>
      <definition
                  value="The period during which this contact person or organization is valid to be contacted relating to this patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication">
      <path value="Patient.communication"/>
      <short
             value="A language which may be used to communicate with the patient about his or her health"/>
      <definition
                  value="A language which may be used to communicate with the patient about his or her health."/>
      <comment
               value="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."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.communication"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="LanguageCommunication"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="patient.languageCommunication"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication"/>
      </mapping>
    </element>
    <element id="Patient.communication.id">
      <path value="Patient.communication.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication.extension">
      <path value="Patient.communication.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication.modifierExtension">
      <path value="Patient.communication.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.communication.language">
      <path value="Patient.communication.language"/>
      <short
             value="The language which can be used to communicate with the patient about his or her health"/>
      <definition
                  value="The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. &quot;en&quot; for English, or &quot;en-US&quot; for American English versus &quot;en-EN&quot; for England English."/>
      <comment
               value="The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type."/>
      <requirements
                    value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.communication.language"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical
                          value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
        </extension>
        <strength value="extensible"/>
        <valueSet value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-15, LAN-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".languageCode"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication.language"/>
      </mapping>
    </element>
    <element id="Patient.communication.preferred">
      <path value="Patient.communication.preferred"/>
      <short value="Language preference indicator"/>
      <definition
                  value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)."/>
      <comment
               value="This language is specifically identified for communicating healthcare information."/>
      <requirements
                    value="People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.communication.preferred"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-15"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="preferenceInd"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".preferenceInd"/>
      </mapping>
    </element>
    <element id="Patient.generalPractitioner">
      <path value="Patient.generalPractitioner"/>
      <short value="Patient&#39;s nominated primary care provider"/>
      <definition value="Patient&#39;s nominated care provider."/>
      <comment
               value="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 &quot;fly-in/fly-out&quot; 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."/>
      <alias value="careProvider"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.generalPractitioner"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PD1-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="subjectOf.CareEvent.performer.AssignedEntity"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.managingOrganization">
      <path value="Patient.managingOrganization"/>
      <short value="Organization that is the custodian of the patient record"/>
      <definition
                  value="Organization that is the custodian of the patient record."/>
      <comment
               value="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)."/>
      <requirements
                    value="Need to know who recognizes this patient record, manages and updates it."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.managingOrganization"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="scoper"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".providerOrganization"/>
      </mapping>
    </element>
    <element id="Patient.link">
      <path value="Patient.link"/>
      <short
             value="Link to another patient resource that concerns the same actual person"/>
      <definition
                  value="Link to another patient resource that concerns the same actual patient."/>
      <comment
               value="There is no assumption that linked patient records have mutual links."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="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 &#39;replaced-by&#39;"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="outboundLink"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.id">
      <path value="Patient.link.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.extension">
      <path value="Patient.link.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.modifierExtension">
      <path value="Patient.link.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.link.other">
      <path value="Patient.link.other"/>
      <short
             value="The other patient or related person resource that the link refers to"/>
      <definition value="The other patient resource that the link refers to."/>
      <comment
               value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.link.other"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy">
          <valueBoolean value="false"/>
        </extension>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3, MRG-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.type">
      <path value="Patient.link.type"/>
      <short value="replaced-by | replaces | refer | seealso"/>
      <definition
                  value="The type of link between this patient resource and another patient resource."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.link.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="LinkType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The type of link between this patient resource and another patient resource."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/link-type|4.0.0"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="typeCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Patient">
      <path value="Patient"/>
      <short value="obf-Patient"/>
      <definition
                  value="A person in the role of a patient. Sometimes, the patient is not the subject of information in a clinical statement where the Patient is the SubjectOfRecord.

Compatibility: Lies at the intersection of Argonaut and US Core Patient. MaritalStatus has a required binding in Argonaut, but an extensible binding in US-Core. To be feasible under both DSTU2 Argonaut and STU3 US-Core, the required binding strength is adopted."/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Patient.deceased[x]">
      <path value="Patient.deceased[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="Patient.maritalStatus">
      <path value="Patient.maritalStatus"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MaritalStatus"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="required"/>
        <description value="The domestic partnership status of a person."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/marital-status"/>
      </binding>
    </element>
    <element id="Patient.contact">
      <path value="Patient.contact"/>
    </element>
    <element id="Patient.contact.organization">
      <path value="Patient.contact.organization"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
    </element>
    <element id="Patient.generalPractitioner">
      <path value="Patient.generalPractitioner"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
    </element>
    <element id="Patient.managingOrganization">
      <path value="Patient.managingOrganization"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
    </element>
    <element id="Patient.link">
      <path value="Patient.link"/>
    </element>
    <element id="Patient.link.other">
      <path value="Patient.link.other"/>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy">
          <valueBoolean value="false"/>
        </extension>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
      </type>
    </element>
  </differential>
</StructureDefinition>