Personal Health Device Implementation Guide
1.0.0 - STU 1

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## Resource Profile: PhdPatient - XML Profile

XML representation of the PhdPatient resource profile.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="PhdPatient"/>
      <meta>
        <lastUpdated value="2017-10-16T05:10:41.036-04:00"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient">Patient</a><a name="Patient"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/patient.html">Patient</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Information about an individual or animal receiving health care services</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.meta">meta</a><a name="Patient.meta"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Meta">Meta</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Metadata about the resource</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-PhdPatient-definitions.html#Patient.meta.profile">Slices for profile</a><a name="Patient.meta.profile"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="font-style: italic" href="http://hl7.org/fhir/R4/references.html">canonical</a><span style="font-style: italic">(</span><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/structuredefinition.html">StructureDefinition</a><span style="font-style: italic">)</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Profiles this resource claims to conform to</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:value</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1024.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.meta.profile:phdProfile" title="Slice phdProfile">profile:phdProfile</a><a name="Patient.meta.profile"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">canonical</a>(<a style="opacity: 0.5" href="http://hl7.org/fhir/R4/structuredefinition.html">StructureDefinition</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Profiles this resource claims to conform to</span><br/><span style="font-weight:bold">Fixed Value: </span><a style="color: darkgreen" href="StructureDefinition-PhdPatient.html">http://hl7.org/fhir/uv/phd/StructureDefinition/PhdPatient</a></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier">identifier</a><a name="Patient.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">An identifier for this patient</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.type">type</a><a name="Patient.identifier.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Description of identifier</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0103.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.type.coding">Slices for coding</a><a name="Patient.identifier.type.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="opacity: 0.5; font-style: italic">0</span><span style="opacity: 0.5; font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Code defined by a terminology system</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:system</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.type.coding:v2Coding" title="Slice v2Coding: A code using the V2 http://terminology.hl7.org/CodeSystem/v2-0203/ system.">coding:v2Coding</a><a name="Patient.identifier.type.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Code defined by http://terminology.hl7.org/CodeSystem/v2-0203</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010250.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.type.coding:v2Coding.system" title="The identification of the code system that defines the meaning of the symbol in the code. In this case the system is http://terminology.hl7.org/CodeSystem/v2-0203">system</a><a name="Patient.identifier.type.coding.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Identity of the terminology system</span><br/><span style="font-weight:bold">Fixed Value: </span><a style="color: darkgreen" href="http://terminology.hl7.org/3.1.0/CodeSystem-v2-0203.html">http://terminology.hl7.org/CodeSystem/v2-0203</a></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.type.coding:v2Coding.code" title="A symbol defined by the http://terminology.hl7.org/CodeSystem/v2-0203 coding system. For example, the code 'MR' indicates the identifier is a Medical Record Number. 'SS' indicates that the identifier value is a US social security number and 'SR' indicates a state registry id.">code</a><a name="Patient.identifier.type.coding.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">a code from http://terminology.hl7.org/CodeSystem/v2-0203</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.system">system</a><a name="Patient.identifier.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The system associated with the value. For XDSb this would be the enterprise identifier (an OID). For unknown patient 'http://terminology.hl7.org/CodeSystem/v2-0004'</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdPatient-definitions.html#Patient.identifier.value">value</a><a name="Patient.identifier.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The patient identifier under the jurisdiction indicated by the system element. For unknown patient this would be 'U'.</td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url value="http://hl7.org/fhir/uv/phd/StructureDefinition/PhdPatient"/>
      <version value="1.0.0"/>
      <name value="PhdPatient"/>
      <status value="draft"/>
      <date value="2017-08-04T06:04:53.838-04:00"/>
      <publisher value="HL7 International - Health Care Devices Work Group"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="http://hl7.org/Special/committees/healthcaredevices"/>
        </telecom>
      </contact>
      <description
                   value="The patient information reported from personal health gateways (PHG)"/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="001"/>
        </coding>
      </jurisdiction>
      <purpose
               value="All PHD related Observation resources reference a Patient resource containing a minimal set of information sufficient to identify the patient. However, it may require additional information to link the patient to a person that is only available to an authorized entity. In this manner, PHMI can be protected."/>
      <fhirVersion value="4.0.1"/>
      <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/StructureDefinition/Patient"/>
      <derivation value="constraint"/>
      <snapshot>
        <element id="Patient">
          <path value="Patient"/>
          <short
                 value="Information about an individual or animal receiving health care services"/>
          <definition
                      value="Demographics and other administrative information about an individual or animal receiving care or other health-related services."/>
          <comment
                   value="Note that the only element that is required to be populated is the identifier which can be made opaque to a third party viewer. PCHA also supports a situation where the PHG can be provided a logical id to a Patient Resource out of band. In this case, the PHG never uploads a Patient Resource, but uses the provided logical id in the Observation resources instead. In this manner, not even the opaque identifiers are sent over the wire."/>
          <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="http://hl7.org/fhir/StructureDefinition/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((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
            <xpath
                   value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
            <source value="http://hl7.org/fhir/StructureDefinition/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="http://hl7.org/fhir/StructureDefinition/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="http://hl7.org/fhir/StructureDefinition/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="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <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>
        </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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </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="1"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.id">
          <path value="Patient.meta.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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.meta.extension">
          <path value="Patient.meta.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.meta.versionId">
          <path value="Patient.meta.versionId"/>
          <short value="Version specific identifier"/>
          <definition
                      value="The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted."/>
          <comment
                   value="The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Meta.versionId"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="id"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.lastUpdated">
          <path value="Patient.meta.lastUpdated"/>
          <short value="When the resource version last changed"/>
          <definition
                      value="When the resource last changed - e.g. when the version changed."/>
          <comment
                   value="This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Meta.lastUpdated"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="instant"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.source">
          <path value="Patient.meta.source"/>
          <short value="Identifies where the resource comes from"/>
          <definition
                      value="A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc."/>
          <comment
                   value="In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

    This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Meta.source"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.profile">
          <path value="Patient.meta.profile"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="value"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <short value="Profiles this resource claims to conform to"/>
          <definition
                      value="A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url)."/>
          <comment
                   value="It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set."/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="Meta.profile"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="canonical"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/StructureDefinition"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.profile:phdProfile">
          <path value="Patient.meta.profile"/>
          <sliceName value="phdProfile"/>
          <short value="Profiles this resource claims to conform to"/>
          <definition
                      value="A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url)."/>
          <comment
                   value="It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Meta.profile"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="canonical"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/StructureDefinition"/>
          </type>
          <fixedCanonical
                          value="http://hl7.org/fhir/uv/phd/StructureDefinition/PhdPatient"/>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta.security">
          <path value="Patient.meta.security"/>
          <short value="Security Labels applied to this resource"/>
          <definition
                      value="Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure."/>
          <comment
                   value="The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Meta.security"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="SecurityLabels"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
              <valueBoolean value="true"/>
            </extension>
            <strength value="extensible"/>
            <description
                         value="Security Labels from the Healthcare Privacy and Security Classification System."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/security-labels"/>
          </binding>
        </element>
        <element id="Patient.meta.tag">
          <path value="Patient.meta.tag"/>
          <short value="Tags applied to this resource"/>
          <definition
                      value="Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource."/>
          <comment
                   value="The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Meta.tag"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Tags"/>
            </extension>
            <strength value="example"/>
            <description
                         value="Codes that represent various types of tags, commonly workflow-related; e.g. &quot;Needs review by Dr. Jones&quot;."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/common-tags"/>
          </binding>
        </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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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"/>
          <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 resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <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="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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|4.0.1"/>
          </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="1"/>
          <max value="1"/>
          <base>
            <path value="Identifier.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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.type.id">
          <path value="Patient.identifier.type.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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.extension">
          <path value="Patient.identifier.type.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding">
          <path value="Patient.identifier.type.coding"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="system"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <short value="Code defined by a terminology system"/>
          <definition value="A reference to a code defined by a terminology system."/>
          <comment value="This element shall be populated."/>
          <requirements
                        value="Allows for alternative encodings within a code system, and translations to other code systems."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="CodeableConcept.coding"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.1-8, C*E.10-22"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="union(., ./translation)"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding">
          <path value="Patient.identifier.type.coding"/>
          <sliceName value="v2Coding"/>
          <short
                 value="Code defined by http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <definition
                      value="A code using the V2 http://terminology.hl7.org/CodeSystem/v2-0203/ system."/>
          <comment
                   value="This HL7 V2 coding system identifies that this is the Continua identifier. The V2 system supports many possible types of identifiers. For a local coding system use 'L', for an unknown identifier, for example with an unknown patient, use 'U'"/>
          <requirements
                        value="Allows for alternative encodings within a code system, and translations to other code systems."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="CodeableConcept.coding"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.1-8, C*E.10-22"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="union(., ./translation)"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.id">
          <path value="Patient.identifier.type.coding.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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.extension">
          <path value="Patient.identifier.type.coding.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.system">
          <path value="Patient.identifier.type.coding.system"/>
          <short value="Identity of the terminology system"/>
          <definition
                      value="The identification of the code system that defines the meaning of the symbol in the code. In this case the system is http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <comment
                   value="HL7 defines several codes that can be used in the http://terminology.hl7.org/CodeSystem/v2-0203 system. For a list of the possible codes in this system see http://www.hl7.org/fhir/CodeSystem/v2-0203"/>
          <requirements
                        value="Need to be unambiguous about the source of the definition of the symbol."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Coding.system"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <fixedUri value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.3"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./codeSystem"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map
                 value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.version">
          <path value="Patient.identifier.type.coding.version"/>
          <short value="Version of the system - if relevant"/>
          <definition
                      value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
          <comment
                   value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Coding.version"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.7"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./codeSystemVersion"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map
                 value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.code">
          <path value="Patient.identifier.type.coding.code"/>
          <short value="a code from http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <definition
                      value="A symbol defined by the http://terminology.hl7.org/CodeSystem/v2-0203 coding system. For example, the code 'MR' indicates the identifier is a Medical Record Number. 'SS' indicates that the identifier value is a US social security number and 'SR' indicates a state registry id."/>
          <requirements value="Need to refer to a particular code in the system."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Coding.code"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.1"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./code"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.display">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
            <valueBoolean value="true"/>
          </extension>
          <path value="Patient.identifier.type.coding.display"/>
          <short value="Representation defined by the system"/>
          <definition
                      value="A representation of the meaning of the code in the system, following the rules of the system."/>
          <requirements
                        value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Coding.display"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.2 - but note this is not well followed"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="CV.displayName"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map
                 value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.userSelected">
          <path value="Patient.identifier.type.coding.userSelected"/>
          <short value="If this coding was chosen directly by the user"/>
          <definition
                      value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
          <comment
                   value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
          <requirements
                        value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Coding.userSelected"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="Sometimes implied by being first"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="CD.codingRationale"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map
                 value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
          </mapping>
        </element>
        <element id="Patient.identifier.type.text">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
            <valueBoolean value="true"/>
          </extension>
          <path value="Patient.identifier.type.text"/>
          <short value="Plain text representation of the concept"/>
          <definition
                      value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
          <comment
                   value="Very often the text is the same as a displayName of one of the codings."/>
          <requirements
                        value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="CodeableConcept.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="C*E.9. But note many systems use C*E.2 for this"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
          </mapping>
          <mapping>
            <identity value="orim"/>
            <map
                 value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
          </mapping>
        </element>
        <element id="Patient.identifier.system">
          <path value="Patient.identifier.system"/>
          <short
                 value="The system associated with the value. For XDSb this would be the enterprise identifier (an OID). For unknown patient 'http://terminology.hl7.org/CodeSystem/v2-0004'"/>
          <definition
                      value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/>
          <comment
                   value="For an unknown patient the system http://terminology.hl7.org/CodeSystem/v2-0004 can be used with value 'U'"/>
          <requirements
                        value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Identifier.system"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <example>
            <label value="General"/>
            <valueUri value="http://www.acme.com/identifiers/patient"/>
          </example>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </element>
        <element id="Patient.identifier.value">
          <path value="Patient.identifier.value"/>
          <short
                 value="The patient identifier under the jurisdiction indicated by the system element. For unknown patient this would be 'U'."/>
          <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'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>
          <example>
            <label value="General"/>
            <valueString value="123456"/>
          </example>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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'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'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"/>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.name"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="HumanName"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </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'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="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.gender"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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|4.0.1"/>
          </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>
        </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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
        </element>
        <element id="Patient.maritalStatus">
          <path value="Patient.maritalStatus"/>
          <short value="Marital (civil) status of a patient"/>
          <definition
                      value="This field contains a patient'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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="extensible"/>
            <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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="pat-1"/>
            <severity value="error"/>
            <human
                   value="SHALL at least contain a contact'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)"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Patient"/>
          </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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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|4.0.1"/>
          </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/StructureDefinition/Organization"/>
          </type>
          <condition value="pat-1"/>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="LanguageCommunication"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="patient.languageCommunication"/>
          </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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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>
        </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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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's nominated primary care provider"/>
          <definition value="Patient'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/StructureDefinition/Organization"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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/StructureDefinition/Organization"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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="http://hl7.org/fhir/StructureDefinition/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 'replaced-by'"/>
          <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>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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'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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <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/StructureDefinition/Patient"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
          </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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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>
          <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="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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|4.0.1"/>
          </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"/>
          <comment
                   value="Note that the only element that is required to be populated is the identifier which can be made opaque to a third party viewer. PCHA also supports a situation where the PHG can be provided a logical id to a Patient Resource out of band. In this case, the PHG never uploads a Patient Resource, but uses the provided logical id in the Observation resources instead. In this manner, not even the opaque identifiers are sent over the wire."/>
        </element>
        <element id="Patient.meta">
          <path value="Patient.meta"/>
          <min value="1"/>
        </element>
        <element id="Patient.meta.profile">
          <path value="Patient.meta.profile"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="value"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <min value="1"/>
        </element>
        <element id="Patient.meta.profile:phdProfile">
          <path value="Patient.meta.profile"/>
          <sliceName value="phdProfile"/>
          <min value="1"/>
          <max value="1"/>
          <fixedCanonical
                          value="http://hl7.org/fhir/uv/phd/StructureDefinition/PhdPatient"/>
        </element>
        <element id="Patient.identifier">
          <path value="Patient.identifier"/>
          <min value="1"/>
        </element>
        <element id="Patient.identifier.type">
          <path value="Patient.identifier.type"/>
          <min value="1"/>
        </element>
        <element id="Patient.identifier.type.coding">
          <path value="Patient.identifier.type.coding"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="system"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <comment value="This element shall be populated."/>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding">
          <path value="Patient.identifier.type.coding"/>
          <sliceName value="v2Coding"/>
          <short
                 value="Code defined by http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <definition
                      value="A code using the V2 http://terminology.hl7.org/CodeSystem/v2-0203/ system."/>
          <comment
                   value="This HL7 V2 coding system identifies that this is the Continua identifier. The V2 system supports many possible types of identifiers. For a local coding system use 'L', for an unknown identifier, for example with an unknown patient, use 'U'"/>
          <min value="1"/>
          <max value="1"/>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.system">
          <path value="Patient.identifier.type.coding.system"/>
          <definition
                      value="The identification of the code system that defines the meaning of the symbol in the code. In this case the system is http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <comment
                   value="HL7 defines several codes that can be used in the http://terminology.hl7.org/CodeSystem/v2-0203 system. For a list of the possible codes in this system see http://www.hl7.org/fhir/CodeSystem/v2-0203"/>
          <min value="1"/>
          <fixedUri value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        </element>
        <element id="Patient.identifier.type.coding:v2Coding.code">
          <path value="Patient.identifier.type.coding.code"/>
          <short value="a code from http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <definition
                      value="A symbol defined by the http://terminology.hl7.org/CodeSystem/v2-0203 coding system. For example, the code 'MR' indicates the identifier is a Medical Record Number. 'SS' indicates that the identifier value is a US social security number and 'SR' indicates a state registry id."/>
          <min value="1"/>
        </element>
        <element id="Patient.identifier.system">
          <path value="Patient.identifier.system"/>
          <short
                 value="The system associated with the value. For XDSb this would be the enterprise identifier (an OID). For unknown patient 'http://terminology.hl7.org/CodeSystem/v2-0004'"/>
          <comment
                   value="For an unknown patient the system http://terminology.hl7.org/CodeSystem/v2-0004 can be used with value 'U'"/>
          <min value="1"/>
        </element>
        <element id="Patient.identifier.value">
          <path value="Patient.identifier.value"/>
          <short
                 value="The patient identifier under the jurisdiction indicated by the system element. For unknown patient this would be 'U'."/>
          <min value="1"/>
        </element>
      </differential>
    </StructureDefinition>