IHE PAM France
0.1.0 - ci-build France (la) drapeau

IHE PAM France - version de développement local (intégration continue v0.1.0) construite par les outils de publication FHIR (HL7® FHIR® Standard). Voir le répertoire des versions publiées

Profil de ressource: IHE France PAM Patient - Descriptions détaillées

Draft à date du 2026-10-20

Définitions pour le ihe-france-pam-patient profil de ressource

Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvés ici on how to interpret the contents of this table

0. Patient
Définition

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

CourtInformation about an individual or animal receiving health care services
Contrôle0..*
Est modificateurfalse
Résuméfalse
Noms alternatifsSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Patient.implicitRules
Définition

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.

CourtA set of rules under which this content was created
Commentaires

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.

Contrôle0..1
Typeuri
Est modificateurtrue parce que 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
Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
Résumétrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.extension
Définition

An Extension


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.

CourtExtensionAdditional content defined by implementations
Commentaires

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.

Contrôle0..*
TypeExtension
Est modificateurfalse
Résuméfalse
Noms alternatifsextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingCet élément introduit un ensemble de slices sur Patient.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
  • value @ url
  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

    6. Patient.extension:identityStatus
    Nom de la sliceidentityStatus
    Définition

    Statut ou attribut de l'identité du patient (PID-32). Répétable : un statut et, le cas échéant, des attributs d'identité.

    CourtIHE France PAM Identity Status
    Contrôle0..*
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Identity Status) (Type d'extension : code)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Patient.extension:dmpStatus
    Nom de la slicedmpStatus
    Définition

    Contexte DMP du patient (segment ZFA) : statut du DMP, information et opposition à l'alimentation, information et consentement à la consultation.

    CourtIHE France PAM DMP Status
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM DMP Status) (Extension complexe)
    Est modificateurfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Patient.extension:identityModifierEntity
    Nom de la sliceidentityModifierEntity
    Définition

    Entité ayant modifié l'identité du patient (PID-34), renseignée dans un contexte de groupement hospitalier de territoire où les identités sont partagées.

    CourtIHE France PAM Identity Modifier Entity
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Identity Modifier Entity) (Type d'extension : Identifier)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Patient.extension:motherBirthName
    Nom de la slicemotherBirthName
    Définition

    Nom de naissance de la mère (PID-6). Ce champ ne porte pas le nom de naissance du patient.

    CourtIHE France PAM Mother Birth Name
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Mother Birth Name) (Type d'extension : HumanName)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Patient.extension:birthMultipleRank
    Nom de la slicebirthMultipleRank
    Définition

    Rang gémellaire (PID-25), entier positif pour un patient issu d'une naissance multiple.

    CourtIHE France PAM Birth Multiple Rank
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Birth Multiple Rank) (Type d'extension : positiveInt)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Patient.extension:nationality
    Nom de la slicenationality
    Définition

    Citoyenneté du patient (PID-26), code pays ISO 3166 alpha-3 par défaut. Le champ PID-28 (nationalité) est déprécié et son usage est interdit en France.

    CourtIHE France PAM Nationality
    Contrôle0..*
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Nationality) (Type d'extension : CodeableConcept)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Patient.extension:professionalSituation
    Nom de la sliceprofessionalSituation
    Définition

    Situation professionnelle du patient (segment ZFP) : activité et catégorie socioprofessionnelles (nomenclature PCS 2003 de l'INSEE).

    CourtIHE France PAM Professional Situation
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Professional Situation) (Extension complexe)
    Est modificateurfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Patient.extension:psychiatricLegalStatus
    Nom de la slicepsychiatricLegalStatus
    Définition

    Mode légal de soins en psychiatrie (segment ZFS, répétable). Un seul système doit être maître de la saisie des modes légaux de soins.

    CourtIHE France PAM Psychiatric Legal Status
    Contrôle0..*
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Psychiatric Legal Status) (Extension complexe)
    Est modificateurfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    22. Patient.extension:demographicComplement
    Nom de la slicedemographicComplement
    Définition

    Complément démographique (segment ZFD) : date lunaire, semaines de gestation, consentement SMS, indicateur de date de naissance corrigée, mode d'obtention et justificatif de l'identité.

    CourtIHE France PAM Demographic Complement
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Demographic Complement) (Extension complexe)
    Est modificateurfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    24. Patient.extension:dataProtection
    Nom de la slicedataProtection
    Définition

    Protection des données du patient (PD1-12) : vrai si l'accès à l'information du patient est protégé, faux si l'accès est normal.

    CourtIHE France PAM Data Protection
    Contrôle0..1
    Cet élément est affecté par les invariants suivants : ele-1
    TypeExtension(IHE France PAM Data Protection) (Type d'extension : boolean)
    Est modificateurfalse
    Résuméfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    26. Patient.modifierExtension
    Définition

    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).

    CourtExtensions that cannot be ignored
    Commentaires

    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.

    Contrôle0..*
    TypeExtension
    Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Résuméfalse
    Exigences

    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.

    Noms alternatifsextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. Patient.identifier
    Définition

    An identifier for this patient.

    CourtAn identifier for this patient
    NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
    Contrôle10..*
    TypeIdentifier
    Est modificateurfalse
    Résumétrue
    Exigences

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingCet élément introduit un ensemble de slices sur Patient.identifier. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
    • value @ type.coding.code
    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

      30. Patient.identifier:ipp
      Nom de la sliceipp
      Définition

      An identifier for this patient.

      CourtIPP d'établissementAn identifier for this patient
      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
      Contrôle0..*
      TypeIdentifier
      Est modificateurfalse
      Résumétrue
      Exigences

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Patient.identifier:ipp.use
      Définition

      The purpose of this identifier.

      Courtusual | official | temp | secondary | old (If known)
      Commentaires

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

      Contrôle0..1
      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Patient.identifier:ipp.type
      Définition

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

      CourtDescription of identifier
      Commentaires

      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.

      Contrôle0..1
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)http://hl7.org/fhir/ValueSet/identifier-type|4.0.1
      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
      TypeCodeableConcept
      Est modificateurfalse
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Patient.identifier:ins
      Nom de la sliceins
      Définition

      Transporté uniquement si l'identité est qualifiée (PID-32 = VALI). L'identifiant est transporté avec sa clé.


      An identifier for this patient.

      CourtIdentifiant national de santé (INS-NIR ou INS-NIA)An identifier for this patient
      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
      Contrôle0..*
      TypeIdentifier
      Est modificateurfalse
      Résumétrue
      Exigences

      Patients are almost always assigned specific numerical identifiers.

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

      The purpose of this identifier.

      Courtusual | official | temp | secondary | old (If known)
      Commentaires

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

      Contrôle0..1
      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Patient.identifier:ins.type
      Définition

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

      CourtDescription of identifier
      Commentaires

      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.

      Contrôle0..1
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)http://hl7.org/fhir/ValueSet/identifier-type|4.0.1
      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
      TypeCodeableConcept
      Est modificateurfalse
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Patient.identifier:insC
      Nom de la sliceinsC
      Définition

      An identifier for this patient.

      CourtIdentifiant national de santé calculé (INS-C)An identifier for this patient
      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
      Contrôle0..*
      TypeIdentifier
      Est modificateurfalse
      Résumétrue
      Exigences

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Patient.identifier:insC.use
      Définition

      The purpose of this identifier.

      Courtusual | official | temp | secondary | old (If known)
      Commentaires

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

      Contrôle0..1
      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Patient.identifier:insC.type
      Définition

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

      CourtDescription of identifier
      Commentaires

      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.

      Contrôle0..1
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)http://hl7.org/fhir/ValueSet/identifier-type|4.0.1
      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
      TypeCodeableConcept
      Est modificateurfalse
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Patient.identifier:nationalHealthId
      Nom de la slicenationalHealthId
      Définition

      An identifier for this patient.

      CourtNIR du bénéficiaire (type NH), distinct de l'INS-NIRAn identifier for this patient
      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
      Contrôle0..*
      TypeIdentifier
      Est modificateurfalse
      Résumétrue
      Exigences

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Patient.identifier:nationalHealthId.use
      Définition

      The purpose of this identifier.

      Courtusual | official | temp | secondary | old (If known)
      Commentaires

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

      Contrôle0..1
      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Patient.identifier:nationalHealthId.type
      Définition

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

      CourtDescription of identifier
      Commentaires

      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.

      Contrôle0..1
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)http://hl7.org/fhir/ValueSet/identifier-type|4.0.1
      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
      TypeCodeableConcept
      Est modificateurfalse
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Patient.identifier:ndp
      Nom de la slicendp
      Définition

      An identifier for this patient.

      CourtIdentifiant du patient au Dossier PharmaceutiqueAn identifier for this patient
      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
      Contrôle0..*
      TypeIdentifier
      Est modificateurfalse
      Résumétrue
      Exigences

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Patient.identifier:ndp.use
      Définition

      The purpose of this identifier.

      Courtusual | official | temp | secondary | old (If known)
      Commentaires

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

      Contrôle0..1
      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. Patient.identifier:ndp.type
      Définition

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

      CourtDescription of identifier
      Commentaires

      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.

      Contrôle0..1
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)http://hl7.org/fhir/ValueSet/identifier-type|4.0.1
      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
      TypeCodeableConcept
      Est modificateurfalse
      Résumétrue
      Exigences

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

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

      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.

      CourtWhether this patient's record is in active use
      Commentaires

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

      Contrôle0..1
      Typeboolean
      Est modificateurtrue parce que 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
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Signification si manquantThis resource is generally assumed to be active if no value is provided for the active element
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Patient.name
      Définition

      A name associated with the individual.

      CourtA name associated with the patient
      Commentaires

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

      Contrôle10..*
      TypeHumanName
      Est modificateurfalse
      Résumétrue
      Exigences

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

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

      Indicates if the individual is deceased or not.

      CourtIndicates if the individual is deceased or not
      Commentaires

      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.

      Contrôle0..1
      TypeChoix de : boolean, dateTime
      Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
      Est modificateurtrue parce que 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.
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Exigences

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. Patient.link
      Définition

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

      CourtLink to another patient resource that concerns the same actual person
      Commentaires

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

      Contrôle0..*
      TypeBackboneElement
      Est modificateurtrue parce que 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'
      Résumétrue
      Exigences

      There are multiple use cases:

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

      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).

      CourtExtensions that cannot be ignored even if unrecognized
      Commentaires

      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.

      Contrôle0..*
      TypeExtension
      Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Résumétrue
      Exigences

      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.

      Noms alternatifsextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      70. Patient.link.other
      Définition

      The other patient resource that the link refers to.

      CourtThe other patient or related person resource that the link refers to
      Commentaires

      Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

      Contrôle1..1
      TypeReference(Patient, RelatedPerson)
      Est modificateurfalse
      Résumétrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. Patient.link.type
      Définition

      The type of link between this patient resource and another patient resource.

      Courtreplaced-by | replaces | refer | seealso
      Contrôle1..1
      BindingLes codes DOIVENT (SHALL) être pris de LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
      (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

      The type of link between this patient resource and another patient resource.

      Typecode
      Est modificateurfalse
      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
      Résumétrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvés ici on how to interpret the contents of this table

      0. Patient
      2. Patient.extension
      SlicingCet élément introduit un ensemble de slices sur Patient.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
      • value @ url
      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

        4. Patient.extension:identityStatus
        Nom de la sliceidentityStatus
        Contrôle0..*
        TypeExtension(IHE France PAM Identity Status) (Type d'extension : code)
        6. Patient.extension:dmpStatus
        Nom de la slicedmpStatus
        Contrôle0..1
        TypeExtension(IHE France PAM DMP Status) (Extension complexe)
        8. Patient.extension:identityModifierEntity
        Nom de la sliceidentityModifierEntity
        Contrôle0..1
        TypeExtension(IHE France PAM Identity Modifier Entity) (Type d'extension : Identifier)
        10. Patient.extension:motherBirthName
        Nom de la slicemotherBirthName
        Contrôle0..1
        TypeExtension(IHE France PAM Mother Birth Name) (Type d'extension : HumanName)
        12. Patient.extension:birthMultipleRank
        Nom de la slicebirthMultipleRank
        Contrôle0..1
        TypeExtension(IHE France PAM Birth Multiple Rank) (Type d'extension : positiveInt)
        14. Patient.extension:nationality
        Nom de la slicenationality
        Contrôle0..*
        TypeExtension(IHE France PAM Nationality) (Type d'extension : CodeableConcept)
        16. Patient.extension:professionalSituation
        Nom de la sliceprofessionalSituation
        Contrôle0..1
        TypeExtension(IHE France PAM Professional Situation) (Extension complexe)
        18. Patient.extension:psychiatricLegalStatus
        Nom de la slicepsychiatricLegalStatus
        Contrôle0..*
        TypeExtension(IHE France PAM Psychiatric Legal Status) (Extension complexe)
        20. Patient.extension:demographicComplement
        Nom de la slicedemographicComplement
        Contrôle0..1
        TypeExtension(IHE France PAM Demographic Complement) (Extension complexe)
        22. Patient.extension:dataProtection
        Nom de la slicedataProtection
        Contrôle0..1
        TypeExtension(IHE France PAM Data Protection) (Type d'extension : boolean)
        24. Patient.identifier
        NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
        Contrôle1..?
        SlicingCet élément introduit un ensemble de slices sur Patient.identifier. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
        • value @ type.coding.code
        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

          26. Patient.identifier:ipp
          Nom de la sliceipp
          CourtIPP d'établissement
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          28. Patient.identifier:ipp.type
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
          (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
          30. Patient.identifier:ipp.type.coding
          32. Patient.identifier:ipp.type.coding.code
          Contrôle1..?
          Valeur de motif
          {
            "code" : "PI"
          }
          <code value="PI"/>
          34. Patient.identifier:ipp.type.coding.display
          Valeur de motif
          {
            "display" : "IPP"
          }
          <display value="IPP"/>
          36. Patient.identifier:ins
          Nom de la sliceins
          Définition

          Transporté uniquement si l'identité est qualifiée (PID-32 = VALI). L'identifiant est transporté avec sa clé.

          CourtIdentifiant national de santé (INS-NIR ou INS-NIA)
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          38. Patient.identifier:ins.type
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
          (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
          40. Patient.identifier:ins.type.coding
          42. Patient.identifier:ins.type.coding.code
          Contrôle1..?
          Valeur de motif
          {
            "code" : "INS"
          }
          <code value="INS"/>
          44. Patient.identifier:ins.type.coding.display
          Valeur de motif
          {
            "display" : "Identifiant National de Santé"
          }
          <display value="Identifiant National de Santé"/>
          46. Patient.identifier:insC
          Nom de la sliceinsC
          CourtIdentifiant national de santé calculé (INS-C)
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          48. Patient.identifier:insC.type
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
          (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
          50. Patient.identifier:insC.type.coding
          52. Patient.identifier:insC.type.coding.code
          Contrôle1..?
          Valeur de motif
          {
            "code" : "INS-C"
          }
          <code value="INS-C"/>
          54. Patient.identifier:insC.type.coding.display
          Valeur de motif
          {
            "display" : "INS-C"
          }
          <display value="INS-C"/>
          56. Patient.identifier:nationalHealthId
          Nom de la slicenationalHealthId
          CourtNIR du bénéficiaire (type NH), distinct de l'INS-NIR
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          58. Patient.identifier:nationalHealthId.type
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
          (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
          60. Patient.identifier:nationalHealthId.type.coding
          62. Patient.identifier:nationalHealthId.type.coding.code
          Contrôle1..?
          Valeur de motif
          {
            "code" : "NH"
          }
          <code value="NH"/>
          64. Patient.identifier:nationalHealthId.type.coding.display
          Valeur de motif
          {
            "display" : "National Health Plan Identifier"
          }
          <display value="National Health Plan Identifier"/>
          66. Patient.identifier:ndp
          Nom de la slicendp
          CourtIdentifiant du patient au Dossier Pharmaceutique
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          68. Patient.identifier:ndp.type
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
          (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
          70. Patient.identifier:ndp.type.coding
          72. Patient.identifier:ndp.type.coding.code
          Contrôle1..?
          Valeur de motif
          {
            "code" : "NDP"
          }
          <code value="NDP"/>
          74. Patient.identifier:ndp.type.coding.display
          Valeur de motif
          {
            "display" : "Identifiant du patient au Dossier Pharmaceutique"
          }
          <display value="Identifiant du patient au Dossier Pharmaceutique"/>
          76. Patient.name
          Contrôle1..?

          Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvés ici on how to interpret the contents of this table

          0. Patient
          Définition

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

          CourtInformation about an individual or animal receiving health care services
          Contrôle0..*
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsSubjectOfCare Client Resident
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. Patient.id
          Définition

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

          CourtLogical id of this artifact
          Commentaires

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

          Contrôle0..1
          Typeid
          Est modificateurfalse
          Résumétrue
          4. Patient.meta
          Définition

          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.

          CourtMetadata about the resource
          Contrôle0..1
          TypeMeta
          Est modificateurfalse
          Résumétrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Patient.implicitRules
          Définition

          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.

          CourtA set of rules under which this content was created
          Commentaires

          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.

          Contrôle0..1
          Typeuri
          Est modificateurtrue parce que 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
          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
          Résumétrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Patient.language
          Définition

          The base language in which the resource is written.

          CourtLanguage of the resource content
          Commentaires

          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).

          Contrôle0..1
          BindingLes codes DEVRAIENT (SHOULD) être pris de CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

          A human language.

          Bindings AdditionnelsBut
          AllLanguagesBinding Max
          Typecode
          Est modificateurfalse
          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
          Résuméfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Patient.text
          Définition

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

          CourtText summary of the resource, for human interpretation
          Commentaires

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

          Contrôle0..1
          TypeNarrative
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Patient.contained
          Définition

          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.

          CourtContained, inline Resources
          Commentaires

          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.

          Contrôle0..*
          TypeResource
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsinline resources, anonymous resources, contained resources
          14. Patient.extension
          Définition

          An Extension

          CourtExtension
          Contrôle0..*
          TypeExtension
          Est modificateurfalse
          Résuméfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingCet élément introduit un ensemble de slices sur Patient.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
          • value @ url
          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

            16. Patient.extension:identityStatus
            Nom de la sliceidentityStatus
            Définition

            Statut ou attribut de l'identité du patient (PID-32). Répétable : un statut et, le cas échéant, des attributs d'identité.

            CourtIHE France PAM Identity Status
            Contrôle0..*
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Identity Status) (Type d'extension : code)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Patient.extension:dmpStatus
            Nom de la slicedmpStatus
            Définition

            Contexte DMP du patient (segment ZFA) : statut du DMP, information et opposition à l'alimentation, information et consentement à la consultation.

            CourtIHE France PAM DMP Status
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM DMP Status) (Extension complexe)
            Est modificateurfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. Patient.extension:identityModifierEntity
            Nom de la sliceidentityModifierEntity
            Définition

            Entité ayant modifié l'identité du patient (PID-34), renseignée dans un contexte de groupement hospitalier de territoire où les identités sont partagées.

            CourtIHE France PAM Identity Modifier Entity
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Identity Modifier Entity) (Type d'extension : Identifier)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. Patient.extension:motherBirthName
            Nom de la slicemotherBirthName
            Définition

            Nom de naissance de la mère (PID-6). Ce champ ne porte pas le nom de naissance du patient.

            CourtIHE France PAM Mother Birth Name
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Mother Birth Name) (Type d'extension : HumanName)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. Patient.extension:birthMultipleRank
            Nom de la slicebirthMultipleRank
            Définition

            Rang gémellaire (PID-25), entier positif pour un patient issu d'une naissance multiple.

            CourtIHE France PAM Birth Multiple Rank
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Birth Multiple Rank) (Type d'extension : positiveInt)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. Patient.extension:nationality
            Nom de la slicenationality
            Définition

            Citoyenneté du patient (PID-26), code pays ISO 3166 alpha-3 par défaut. Le champ PID-28 (nationalité) est déprécié et son usage est interdit en France.

            CourtIHE France PAM Nationality
            Contrôle0..*
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Nationality) (Type d'extension : CodeableConcept)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. Patient.extension:professionalSituation
            Nom de la sliceprofessionalSituation
            Définition

            Situation professionnelle du patient (segment ZFP) : activité et catégorie socioprofessionnelles (nomenclature PCS 2003 de l'INSEE).

            CourtIHE France PAM Professional Situation
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Professional Situation) (Extension complexe)
            Est modificateurfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. Patient.extension:psychiatricLegalStatus
            Nom de la slicepsychiatricLegalStatus
            Définition

            Mode légal de soins en psychiatrie (segment ZFS, répétable). Un seul système doit être maître de la saisie des modes légaux de soins.

            CourtIHE France PAM Psychiatric Legal Status
            Contrôle0..*
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Psychiatric Legal Status) (Extension complexe)
            Est modificateurfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            32. Patient.extension:demographicComplement
            Nom de la slicedemographicComplement
            Définition

            Complément démographique (segment ZFD) : date lunaire, semaines de gestation, consentement SMS, indicateur de date de naissance corrigée, mode d'obtention et justificatif de l'identité.

            CourtIHE France PAM Demographic Complement
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Demographic Complement) (Extension complexe)
            Est modificateurfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            34. Patient.extension:dataProtection
            Nom de la slicedataProtection
            Définition

            Protection des données du patient (PD1-12) : vrai si l'accès à l'information du patient est protégé, faux si l'accès est normal.

            CourtIHE France PAM Data Protection
            Contrôle0..1
            Cet élément est affecté par les invariants suivants : ele-1
            TypeExtension(IHE France PAM Data Protection) (Type d'extension : boolean)
            Est modificateurfalse
            Résuméfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            36. Patient.modifierExtension
            Définition

            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).

            CourtExtensions that cannot be ignored
            Commentaires

            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.

            Contrôle0..*
            TypeExtension
            Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Résuméfalse
            Exigences

            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.

            Noms alternatifsextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            38. Patient.identifier
            Définition

            An identifier for this patient.

            CourtAn identifier for this patient
            NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
            Contrôle1..*
            TypeIdentifier
            Est modificateurfalse
            Résumétrue
            Exigences

            Patients are almost always assigned specific numerical identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingCet élément introduit un ensemble de slices sur Patient.identifier. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
            • value @ type.coding.code
            • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

              40. Patient.identifier:ipp
              Nom de la sliceipp
              Définition

              An identifier for this patient.

              CourtIPP d'établissement
              NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
              Contrôle0..*
              TypeIdentifier
              Est modificateurfalse
              Résumétrue
              Exigences

              Patients are almost always assigned specific numerical identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. Patient.identifier:ipp.id
              Définition

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

              CourtUnique id for inter-element referencing
              Contrôle0..1
              Typestring
              Est modificateurfalse
              Format XMLDans le format XML, cette propriété est représentée comme attribut.
              Résuméfalse
              44. Patient.identifier:ipp.extension
              Définition

              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.

              CourtAdditional content defined by implementations
              Commentaires

              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.

              Contrôle0..*
              TypeExtension
              Est modificateurfalse
              Résuméfalse
              Noms alternatifsextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingCet élément introduit un ensemble de slices sur Patient.identifier.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
              • value @ url
              • 46. Patient.identifier:ipp.use
                Définition

                The purpose of this identifier.

                Courtusual | official | temp | secondary | old (If known)
                Commentaires

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

                Contrôle0..1
                BindingLes codes DOIVENT (SHALL) être pris de IdentifierUse
                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                Identifies the purpose for this identifier, if known .

                Typecode
                Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                Résumétrue
                Exigences

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

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

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

                CourtDescription of identifier
                Commentaires

                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.

                Contrôle0..1
                BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
                (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
                TypeCodeableConcept
                Est modificateurfalse
                Résumétrue
                Exigences

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

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

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

                CourtUnique id for inter-element referencing
                Contrôle0..1
                Typestring
                Est modificateurfalse
                Format XMLDans le format XML, cette propriété est représentée comme attribut.
                Résuméfalse
                52. Patient.identifier:ipp.type.extension
                Définition

                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.

                CourtAdditional content defined by implementations
                Commentaires

                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.

                Contrôle0..*
                TypeExtension
                Est modificateurfalse
                Résuméfalse
                Noms alternatifsextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                • value @ url
                • 54. Patient.identifier:ipp.type.coding
                  Définition

                  A reference to a code defined by a terminology system.

                  CourtCode defined by a terminology system
                  Commentaires

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Contrôle0..*
                  TypeCoding
                  Est modificateurfalse
                  Résumétrue
                  Exigences

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Patient.identifier:ipp.type.coding.id
                  Définition

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

                  CourtUnique id for inter-element referencing
                  Contrôle0..1
                  Typestring
                  Est modificateurfalse
                  Format XMLDans le format XML, cette propriété est représentée comme attribut.
                  Résuméfalse
                  58. Patient.identifier:ipp.type.coding.extension
                  Définition

                  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.

                  CourtAdditional content defined by implementations
                  Commentaires

                  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.

                  Contrôle0..*
                  TypeExtension
                  Est modificateurfalse
                  Résuméfalse
                  Noms alternatifsextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.coding.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                  • value @ url
                  • 60. Patient.identifier:ipp.type.coding.system
                    Définition

                    The identification of the code system that defines the meaning of the symbol in the code.

                    CourtIdentity of the terminology system
                    Commentaires

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                    Contrôle0..1
                    Typeuri
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    Need to be unambiguous about the source of the definition of the symbol.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. Patient.identifier:ipp.type.coding.version
                    Définition

                    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.

                    CourtVersion of the system - if relevant
                    Commentaires

                    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.

                    NoteCeci est un ID de version métier, pas un ID de version de ressource (voir discussion)
                    Contrôle0..1
                    Typestring
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. Patient.identifier:ipp.type.coding.code
                    Définition

                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                    CourtSymbol in syntax defined by the system
                    Contrôle1..1
                    Typecode
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    Need to refer to a particular code in the system.

                    Valeur de motif
                    {
                      "code" : "PI"
                    }
                    <code value="PI"/>
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. Patient.identifier:ipp.type.coding.display
                    Définition

                    A representation of the meaning of the code in the system, following the rules of the system.

                    CourtRepresentation defined by the system
                    Contrôle0..1
                    Typestring
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Valeur de motif
                    {
                      "display" : "IPP"
                    }
                    <display value="IPP"/>
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Patient.identifier:ipp.type.coding.userSelected
                    Définition

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    CourtIf this coding was chosen directly by the user
                    Commentaires

                    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.

                    Contrôle0..1
                    Typeboolean
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. Patient.identifier:ipp.type.text
                    Définition

                    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.

                    CourtPlain text representation of the concept
                    Commentaires

                    Very often the text is the same as a displayName of one of the codings.

                    Contrôle0..1
                    Typestring
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    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.

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

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

                    CourtThe namespace for the identifier value
                    Commentaires

                    Identifier.system is always case sensitive.

                    Contrôle0..1
                    Typeuri
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    Exigences

                    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.

                    ExempleGeneral: http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. Patient.identifier:ipp.value
                    Définition

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

                    CourtThe value that is unique
                    Commentaires

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

                    Contrôle0..1
                    Typestring
                    Est modificateurfalse
                    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                    Résumétrue
                    ExempleGeneral: 123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    76. Patient.identifier:ipp.period
                    Définition

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

                    CourtTime period when id is/was valid for use
                    Contrôle0..1
                    TypePeriod
                    Est modificateurfalse
                    Résumétrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. Patient.identifier:ipp.assigner
                    Définition

                    Organization that issued/manages the identifier.

                    CourtOrganization that issued id (may be just text)
                    Commentaires

                    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.

                    Contrôle0..1
                    TypeReference(Organization)
                    Est modificateurfalse
                    Résumétrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. Patient.identifier:ins
                    Nom de la sliceins
                    Définition

                    Transporté uniquement si l'identité est qualifiée (PID-32 = VALI). L'identifiant est transporté avec sa clé.

                    CourtIdentifiant national de santé (INS-NIR ou INS-NIA)
                    NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
                    Contrôle0..*
                    TypeIdentifier
                    Est modificateurfalse
                    Résumétrue
                    Exigences

                    Patients are almost always assigned specific numerical identifiers.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. Patient.identifier:ins.id
                    Définition

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

                    CourtUnique id for inter-element referencing
                    Contrôle0..1
                    Typestring
                    Est modificateurfalse
                    Format XMLDans le format XML, cette propriété est représentée comme attribut.
                    Résuméfalse
                    84. Patient.identifier:ins.extension
                    Définition

                    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.

                    CourtAdditional content defined by implementations
                    Commentaires

                    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.

                    Contrôle0..*
                    TypeExtension
                    Est modificateurfalse
                    Résuméfalse
                    Noms alternatifsextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingCet élément introduit un ensemble de slices sur Patient.identifier.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                    • value @ url
                    • 86. Patient.identifier:ins.use
                      Définition

                      The purpose of this identifier.

                      Courtusual | official | temp | secondary | old (If known)
                      Commentaires

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

                      Contrôle0..1
                      BindingLes codes DOIVENT (SHALL) être pris de IdentifierUse
                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                      Identifies the purpose for this identifier, if known .

                      Typecode
                      Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                      Résumétrue
                      Exigences

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

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

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

                      CourtDescription of identifier
                      Commentaires

                      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.

                      Contrôle0..1
                      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
                      (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
                      TypeCodeableConcept
                      Est modificateurfalse
                      Résumétrue
                      Exigences

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

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

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

                      CourtUnique id for inter-element referencing
                      Contrôle0..1
                      Typestring
                      Est modificateurfalse
                      Format XMLDans le format XML, cette propriété est représentée comme attribut.
                      Résuméfalse
                      92. Patient.identifier:ins.type.extension
                      Définition

                      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.

                      CourtAdditional content defined by implementations
                      Commentaires

                      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.

                      Contrôle0..*
                      TypeExtension
                      Est modificateurfalse
                      Résuméfalse
                      Noms alternatifsextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                      • value @ url
                      • 94. Patient.identifier:ins.type.coding
                        Définition

                        A reference to a code defined by a terminology system.

                        CourtCode defined by a terminology system
                        Commentaires

                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                        Contrôle0..*
                        TypeCoding
                        Est modificateurfalse
                        Résumétrue
                        Exigences

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. Patient.identifier:ins.type.coding.id
                        Définition

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

                        CourtUnique id for inter-element referencing
                        Contrôle0..1
                        Typestring
                        Est modificateurfalse
                        Format XMLDans le format XML, cette propriété est représentée comme attribut.
                        Résuméfalse
                        98. Patient.identifier:ins.type.coding.extension
                        Définition

                        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.

                        CourtAdditional content defined by implementations
                        Commentaires

                        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.

                        Contrôle0..*
                        TypeExtension
                        Est modificateurfalse
                        Résuméfalse
                        Noms alternatifsextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.coding.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                        • value @ url
                        • 100. Patient.identifier:ins.type.coding.system
                          Définition

                          The identification of the code system that defines the meaning of the symbol in the code.

                          CourtIdentity of the terminology system
                          Commentaires

                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                          Contrôle0..1
                          Typeuri
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          Need to be unambiguous about the source of the definition of the symbol.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. Patient.identifier:ins.type.coding.version
                          Définition

                          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.

                          CourtVersion of the system - if relevant
                          Commentaires

                          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.

                          NoteCeci est un ID de version métier, pas un ID de version de ressource (voir discussion)
                          Contrôle0..1
                          Typestring
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          104. Patient.identifier:ins.type.coding.code
                          Définition

                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                          CourtSymbol in syntax defined by the system
                          Contrôle1..1
                          Typecode
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          Need to refer to a particular code in the system.

                          Valeur de motif
                          {
                            "code" : "INS"
                          }
                          <code value="INS"/>
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          106. Patient.identifier:ins.type.coding.display
                          Définition

                          A representation of the meaning of the code in the system, following the rules of the system.

                          CourtRepresentation defined by the system
                          Contrôle0..1
                          Typestring
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                          Valeur de motif
                          {
                            "display" : "Identifiant National de Santé"
                          }
                          <display value="Identifiant National de Santé"/>
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. Patient.identifier:ins.type.coding.userSelected
                          Définition

                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                          CourtIf this coding was chosen directly by the user
                          Commentaires

                          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.

                          Contrôle0..1
                          Typeboolean
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          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.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          110. Patient.identifier:ins.type.text
                          Définition

                          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.

                          CourtPlain text representation of the concept
                          Commentaires

                          Very often the text is the same as a displayName of one of the codings.

                          Contrôle0..1
                          Typestring
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          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.

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

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

                          CourtThe namespace for the identifier value
                          Commentaires

                          Identifier.system is always case sensitive.

                          Contrôle0..1
                          Typeuri
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          Exigences

                          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.

                          ExempleGeneral: http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. Patient.identifier:ins.value
                          Définition

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

                          CourtThe value that is unique
                          Commentaires

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

                          Contrôle0..1
                          Typestring
                          Est modificateurfalse
                          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                          Résumétrue
                          ExempleGeneral: 123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. Patient.identifier:ins.period
                          Définition

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

                          CourtTime period when id is/was valid for use
                          Contrôle0..1
                          TypePeriod
                          Est modificateurfalse
                          Résumétrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. Patient.identifier:ins.assigner
                          Définition

                          Organization that issued/manages the identifier.

                          CourtOrganization that issued id (may be just text)
                          Commentaires

                          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.

                          Contrôle0..1
                          TypeReference(Organization)
                          Est modificateurfalse
                          Résumétrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          120. Patient.identifier:insC
                          Nom de la sliceinsC
                          Définition

                          An identifier for this patient.

                          CourtIdentifiant national de santé calculé (INS-C)
                          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
                          Contrôle0..*
                          TypeIdentifier
                          Est modificateurfalse
                          Résumétrue
                          Exigences

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          122. Patient.identifier:insC.id
                          Définition

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

                          CourtUnique id for inter-element referencing
                          Contrôle0..1
                          Typestring
                          Est modificateurfalse
                          Format XMLDans le format XML, cette propriété est représentée comme attribut.
                          Résuméfalse
                          124. Patient.identifier:insC.extension
                          Définition

                          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.

                          CourtAdditional content defined by implementations
                          Commentaires

                          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.

                          Contrôle0..*
                          TypeExtension
                          Est modificateurfalse
                          Résuméfalse
                          Noms alternatifsextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingCet élément introduit un ensemble de slices sur Patient.identifier.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                          • value @ url
                          • 126. Patient.identifier:insC.use
                            Définition

                            The purpose of this identifier.

                            Courtusual | official | temp | secondary | old (If known)
                            Commentaires

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

                            Contrôle0..1
                            BindingLes codes DOIVENT (SHALL) être pris de IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                            Identifies the purpose for this identifier, if known .

                            Typecode
                            Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                            Résumétrue
                            Exigences

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

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

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

                            CourtDescription of identifier
                            Commentaires

                            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.

                            Contrôle0..1
                            BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
                            (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
                            TypeCodeableConcept
                            Est modificateurfalse
                            Résumétrue
                            Exigences

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

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

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

                            CourtUnique id for inter-element referencing
                            Contrôle0..1
                            Typestring
                            Est modificateurfalse
                            Format XMLDans le format XML, cette propriété est représentée comme attribut.
                            Résuméfalse
                            132. Patient.identifier:insC.type.extension
                            Définition

                            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.

                            CourtAdditional content defined by implementations
                            Commentaires

                            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.

                            Contrôle0..*
                            TypeExtension
                            Est modificateurfalse
                            Résuméfalse
                            Noms alternatifsextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                            • value @ url
                            • 134. Patient.identifier:insC.type.coding
                              Définition

                              A reference to a code defined by a terminology system.

                              CourtCode defined by a terminology system
                              Commentaires

                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                              Contrôle0..*
                              TypeCoding
                              Est modificateurfalse
                              Résumétrue
                              Exigences

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. Patient.identifier:insC.type.coding.id
                              Définition

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

                              CourtUnique id for inter-element referencing
                              Contrôle0..1
                              Typestring
                              Est modificateurfalse
                              Format XMLDans le format XML, cette propriété est représentée comme attribut.
                              Résuméfalse
                              138. Patient.identifier:insC.type.coding.extension
                              Définition

                              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.

                              CourtAdditional content defined by implementations
                              Commentaires

                              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.

                              Contrôle0..*
                              TypeExtension
                              Est modificateurfalse
                              Résuméfalse
                              Noms alternatifsextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.coding.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                              • value @ url
                              • 140. Patient.identifier:insC.type.coding.system
                                Définition

                                The identification of the code system that defines the meaning of the symbol in the code.

                                CourtIdentity of the terminology system
                                Commentaires

                                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                Contrôle0..1
                                Typeuri
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                Need to be unambiguous about the source of the definition of the symbol.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                142. Patient.identifier:insC.type.coding.version
                                Définition

                                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.

                                CourtVersion of the system - if relevant
                                Commentaires

                                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.

                                NoteCeci est un ID de version métier, pas un ID de version de ressource (voir discussion)
                                Contrôle0..1
                                Typestring
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                144. Patient.identifier:insC.type.coding.code
                                Définition

                                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                CourtSymbol in syntax defined by the system
                                Contrôle1..1
                                Typecode
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                Need to refer to a particular code in the system.

                                Valeur de motif
                                {
                                  "code" : "INS-C"
                                }
                                <code value="INS-C"/>
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                146. Patient.identifier:insC.type.coding.display
                                Définition

                                A representation of the meaning of the code in the system, following the rules of the system.

                                CourtRepresentation defined by the system
                                Contrôle0..1
                                Typestring
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                Valeur de motif
                                {
                                  "display" : "INS-C"
                                }
                                <display value="INS-C"/>
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                148. Patient.identifier:insC.type.coding.userSelected
                                Définition

                                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                CourtIf this coding was chosen directly by the user
                                Commentaires

                                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.

                                Contrôle0..1
                                Typeboolean
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                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.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                150. Patient.identifier:insC.type.text
                                Définition

                                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.

                                CourtPlain text representation of the concept
                                Commentaires

                                Very often the text is the same as a displayName of one of the codings.

                                Contrôle0..1
                                Typestring
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                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.

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

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

                                CourtThe namespace for the identifier value
                                Commentaires

                                Identifier.system is always case sensitive.

                                Contrôle0..1
                                Typeuri
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                Exigences

                                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.

                                ExempleGeneral: http://www.acme.com/identifiers/patient
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                154. Patient.identifier:insC.value
                                Définition

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

                                CourtThe value that is unique
                                Commentaires

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

                                Contrôle0..1
                                Typestring
                                Est modificateurfalse
                                Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                Résumétrue
                                ExempleGeneral: 123456
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. Patient.identifier:insC.period
                                Définition

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

                                CourtTime period when id is/was valid for use
                                Contrôle0..1
                                TypePeriod
                                Est modificateurfalse
                                Résumétrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. Patient.identifier:insC.assigner
                                Définition

                                Organization that issued/manages the identifier.

                                CourtOrganization that issued id (may be just text)
                                Commentaires

                                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.

                                Contrôle0..1
                                TypeReference(Organization)
                                Est modificateurfalse
                                Résumétrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                160. Patient.identifier:nationalHealthId
                                Nom de la slicenationalHealthId
                                Définition

                                An identifier for this patient.

                                CourtNIR du bénéficiaire (type NH), distinct de l'INS-NIR
                                NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
                                Contrôle0..*
                                TypeIdentifier
                                Est modificateurfalse
                                Résumétrue
                                Exigences

                                Patients are almost always assigned specific numerical identifiers.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                162. Patient.identifier:nationalHealthId.id
                                Définition

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

                                CourtUnique id for inter-element referencing
                                Contrôle0..1
                                Typestring
                                Est modificateurfalse
                                Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                Résuméfalse
                                164. Patient.identifier:nationalHealthId.extension
                                Définition

                                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.

                                CourtAdditional content defined by implementations
                                Commentaires

                                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.

                                Contrôle0..*
                                TypeExtension
                                Est modificateurfalse
                                Résuméfalse
                                Noms alternatifsextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingCet élément introduit un ensemble de slices sur Patient.identifier.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                • value @ url
                                • 166. Patient.identifier:nationalHealthId.use
                                  Définition

                                  The purpose of this identifier.

                                  Courtusual | official | temp | secondary | old (If known)
                                  Commentaires

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

                                  Contrôle0..1
                                  BindingLes codes DOIVENT (SHALL) être pris de IdentifierUse
                                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                  Identifies the purpose for this identifier, if known .

                                  Typecode
                                  Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                  Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                  Résumétrue
                                  Exigences

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

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

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

                                  CourtDescription of identifier
                                  Commentaires

                                  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.

                                  Contrôle0..1
                                  BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
                                  (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
                                  TypeCodeableConcept
                                  Est modificateurfalse
                                  Résumétrue
                                  Exigences

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

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

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

                                  CourtUnique id for inter-element referencing
                                  Contrôle0..1
                                  Typestring
                                  Est modificateurfalse
                                  Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                  Résuméfalse
                                  172. Patient.identifier:nationalHealthId.type.extension
                                  Définition

                                  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.

                                  CourtAdditional content defined by implementations
                                  Commentaires

                                  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.

                                  Contrôle0..*
                                  TypeExtension
                                  Est modificateurfalse
                                  Résuméfalse
                                  Noms alternatifsextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                  • value @ url
                                  • 174. Patient.identifier:nationalHealthId.type.coding
                                    Définition

                                    A reference to a code defined by a terminology system.

                                    CourtCode defined by a terminology system
                                    Commentaires

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Contrôle0..*
                                    TypeCoding
                                    Est modificateurfalse
                                    Résumétrue
                                    Exigences

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    176. Patient.identifier:nationalHealthId.type.coding.id
                                    Définition

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

                                    CourtUnique id for inter-element referencing
                                    Contrôle0..1
                                    Typestring
                                    Est modificateurfalse
                                    Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                    Résuméfalse
                                    178. Patient.identifier:nationalHealthId.type.coding.extension
                                    Définition

                                    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.

                                    CourtAdditional content defined by implementations
                                    Commentaires

                                    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.

                                    Contrôle0..*
                                    TypeExtension
                                    Est modificateurfalse
                                    Résuméfalse
                                    Noms alternatifsextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.coding.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                    • value @ url
                                    • 180. Patient.identifier:nationalHealthId.type.coding.system
                                      Définition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      CourtIdentity of the terminology system
                                      Commentaires

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                      Contrôle0..1
                                      Typeuri
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      182. Patient.identifier:nationalHealthId.type.coding.version
                                      Définition

                                      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.

                                      CourtVersion of the system - if relevant
                                      Commentaires

                                      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.

                                      NoteCeci est un ID de version métier, pas un ID de version de ressource (voir discussion)
                                      Contrôle0..1
                                      Typestring
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      184. Patient.identifier:nationalHealthId.type.coding.code
                                      Définition

                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                      CourtSymbol in syntax defined by the system
                                      Contrôle1..1
                                      Typecode
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      Need to refer to a particular code in the system.

                                      Valeur de motif
                                      {
                                        "code" : "NH"
                                      }
                                      <code value="NH"/>
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      186. Patient.identifier:nationalHealthId.type.coding.display
                                      Définition

                                      A representation of the meaning of the code in the system, following the rules of the system.

                                      CourtRepresentation defined by the system
                                      Contrôle0..1
                                      Typestring
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                      Valeur de motif
                                      {
                                        "display" : "National Health Plan Identifier"
                                      }
                                      <display value="National Health Plan Identifier"/>
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      188. Patient.identifier:nationalHealthId.type.coding.userSelected
                                      Définition

                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                      CourtIf this coding was chosen directly by the user
                                      Commentaires

                                      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.

                                      Contrôle0..1
                                      Typeboolean
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      190. Patient.identifier:nationalHealthId.type.text
                                      Définition

                                      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.

                                      CourtPlain text representation of the concept
                                      Commentaires

                                      Very often the text is the same as a displayName of one of the codings.

                                      Contrôle0..1
                                      Typestring
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      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.

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

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

                                      CourtThe namespace for the identifier value
                                      Commentaires

                                      Identifier.system is always case sensitive.

                                      Contrôle0..1
                                      Typeuri
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      Exigences

                                      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.

                                      ExempleGeneral: http://www.acme.com/identifiers/patient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      194. Patient.identifier:nationalHealthId.value
                                      Définition

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

                                      CourtThe value that is unique
                                      Commentaires

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

                                      Contrôle0..1
                                      Typestring
                                      Est modificateurfalse
                                      Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                      Résumétrue
                                      ExempleGeneral: 123456
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      196. Patient.identifier:nationalHealthId.period
                                      Définition

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

                                      CourtTime period when id is/was valid for use
                                      Contrôle0..1
                                      TypePeriod
                                      Est modificateurfalse
                                      Résumétrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      198. Patient.identifier:nationalHealthId.assigner
                                      Définition

                                      Organization that issued/manages the identifier.

                                      CourtOrganization that issued id (may be just text)
                                      Commentaires

                                      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.

                                      Contrôle0..1
                                      TypeReference(Organization)
                                      Est modificateurfalse
                                      Résumétrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      200. Patient.identifier:ndp
                                      Nom de la slicendp
                                      Définition

                                      An identifier for this patient.

                                      CourtIdentifiant du patient au Dossier Pharmaceutique
                                      NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
                                      Contrôle0..*
                                      TypeIdentifier
                                      Est modificateurfalse
                                      Résumétrue
                                      Exigences

                                      Patients are almost always assigned specific numerical identifiers.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      202. Patient.identifier:ndp.id
                                      Définition

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

                                      CourtUnique id for inter-element referencing
                                      Contrôle0..1
                                      Typestring
                                      Est modificateurfalse
                                      Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                      Résuméfalse
                                      204. Patient.identifier:ndp.extension
                                      Définition

                                      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.

                                      CourtAdditional content defined by implementations
                                      Commentaires

                                      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.

                                      Contrôle0..*
                                      TypeExtension
                                      Est modificateurfalse
                                      Résuméfalse
                                      Noms alternatifsextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingCet élément introduit un ensemble de slices sur Patient.identifier.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                      • value @ url
                                      • 206. Patient.identifier:ndp.use
                                        Définition

                                        The purpose of this identifier.

                                        Courtusual | official | temp | secondary | old (If known)
                                        Commentaires

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

                                        Contrôle0..1
                                        BindingLes codes DOIVENT (SHALL) être pris de IdentifierUse
                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                        Identifies the purpose for this identifier, if known .

                                        Typecode
                                        Est modificateurtrue parce que This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                        Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                        Résumétrue
                                        Exigences

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

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

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

                                        CourtDescription of identifier
                                        Commentaires

                                        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.

                                        Contrôle0..1
                                        BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de IHEFrancePamIdentifierTypeVS (0.1.0)
                                        (extensible to https://hl7.fr/ig/v2/pam/ValueSet/ihe-france-pam-identifier-type-vs|0.1.0)
                                        TypeCodeableConcept
                                        Est modificateurfalse
                                        Résumétrue
                                        Exigences

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

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

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

                                        CourtUnique id for inter-element referencing
                                        Contrôle0..1
                                        Typestring
                                        Est modificateurfalse
                                        Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                        Résuméfalse
                                        212. Patient.identifier:ndp.type.extension
                                        Définition

                                        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.

                                        CourtAdditional content defined by implementations
                                        Commentaires

                                        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.

                                        Contrôle0..*
                                        TypeExtension
                                        Est modificateurfalse
                                        Résuméfalse
                                        Noms alternatifsextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                        • value @ url
                                        • 214. Patient.identifier:ndp.type.coding
                                          Définition

                                          A reference to a code defined by a terminology system.

                                          CourtCode defined by a terminology system
                                          Commentaires

                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                          Contrôle0..*
                                          TypeCoding
                                          Est modificateurfalse
                                          Résumétrue
                                          Exigences

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          216. Patient.identifier:ndp.type.coding.id
                                          Définition

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

                                          CourtUnique id for inter-element referencing
                                          Contrôle0..1
                                          Typestring
                                          Est modificateurfalse
                                          Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                          Résuméfalse
                                          218. Patient.identifier:ndp.type.coding.extension
                                          Définition

                                          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.

                                          CourtAdditional content defined by implementations
                                          Commentaires

                                          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.

                                          Contrôle0..*
                                          TypeExtension
                                          Est modificateurfalse
                                          Résuméfalse
                                          Noms alternatifsextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingCet élément introduit un ensemble de slices sur Patient.identifier.type.coding.extension. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
                                          • value @ url
                                          • 220. Patient.identifier:ndp.type.coding.system
                                            Définition

                                            The identification of the code system that defines the meaning of the symbol in the code.

                                            CourtIdentity of the terminology system
                                            Commentaires

                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                            Contrôle0..1
                                            Typeuri
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            Need to be unambiguous about the source of the definition of the symbol.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            222. Patient.identifier:ndp.type.coding.version
                                            Définition

                                            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.

                                            CourtVersion of the system - if relevant
                                            Commentaires

                                            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.

                                            NoteCeci est un ID de version métier, pas un ID de version de ressource (voir discussion)
                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            224. Patient.identifier:ndp.type.coding.code
                                            Définition

                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                            CourtSymbol in syntax defined by the system
                                            Contrôle1..1
                                            Typecode
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            Need to refer to a particular code in the system.

                                            Valeur de motif
                                            {
                                              "code" : "NDP"
                                            }
                                            <code value="NDP"/>
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            226. Patient.identifier:ndp.type.coding.display
                                            Définition

                                            A representation of the meaning of the code in the system, following the rules of the system.

                                            CourtRepresentation defined by the system
                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                            Valeur de motif
                                            {
                                              "display" : "Identifiant du patient au Dossier Pharmaceutique"
                                            }
                                            <display value="Identifiant du patient au Dossier Pharmaceutique"/>
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            228. Patient.identifier:ndp.type.coding.userSelected
                                            Définition

                                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                            CourtIf this coding was chosen directly by the user
                                            Commentaires

                                            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.

                                            Contrôle0..1
                                            Typeboolean
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            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.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            230. Patient.identifier:ndp.type.text
                                            Définition

                                            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.

                                            CourtPlain text representation of the concept
                                            Commentaires

                                            Very often the text is the same as a displayName of one of the codings.

                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            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.

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

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

                                            CourtThe namespace for the identifier value
                                            Commentaires

                                            Identifier.system is always case sensitive.

                                            Contrôle0..1
                                            Typeuri
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            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.

                                            ExempleGeneral: http://www.acme.com/identifiers/patient
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            234. Patient.identifier:ndp.value
                                            Définition

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

                                            CourtThe value that is unique
                                            Commentaires

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

                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            ExempleGeneral: 123456
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            236. Patient.identifier:ndp.period
                                            Définition

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

                                            CourtTime period when id is/was valid for use
                                            Contrôle0..1
                                            TypePeriod
                                            Est modificateurfalse
                                            Résumétrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            238. Patient.identifier:ndp.assigner
                                            Définition

                                            Organization that issued/manages the identifier.

                                            CourtOrganization that issued id (may be just text)
                                            Commentaires

                                            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.

                                            Contrôle0..1
                                            TypeReference(Organization)
                                            Est modificateurfalse
                                            Résumétrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            240. Patient.active
                                            Définition

                                            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.

                                            CourtWhether this patient's record is in active use
                                            Commentaires

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

                                            Contrôle0..1
                                            Typeboolean
                                            Est modificateurtrue parce que 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
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

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

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

                                            A name associated with the individual.

                                            CourtA name associated with the patient
                                            Commentaires

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

                                            Contrôle1..*
                                            TypeHumanName
                                            Est modificateurfalse
                                            Résumétrue
                                            Exigences

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

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

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

                                            CourtA contact detail for the individual
                                            Commentaires

                                            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).

                                            Contrôle0..*
                                            TypeContactPoint
                                            Est modificateurfalse
                                            Résumétrue
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            246. Patient.gender
                                            Définition

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

                                            Courtmale | female | other | unknown
                                            Commentaires

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

                                            Contrôle0..1
                                            BindingLes codes DOIVENT (SHALL) être pris de AdministrativeGender
                                            (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                            The gender of a person used for administrative purposes.

                                            Typecode
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

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

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

                                            The date of birth for the individual.

                                            CourtThe date of birth for the individual
                                            Commentaires

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

                                            Contrôle0..1
                                            Typedate
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

                                            Age of the individual drives many clinical processes.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            Code LOINC21112-8
                                            250. Patient.deceased[x]
                                            Définition

                                            Indicates if the individual is deceased or not.

                                            CourtIndicates if the individual is deceased or not
                                            Commentaires

                                            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.

                                            Contrôle0..1
                                            TypeChoix de : boolean, dateTime
                                            Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
                                            Est modificateurtrue parce que 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.
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Exigences

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

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

                                            An address for the individual.

                                            CourtAn address for the individual
                                            Commentaires

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

                                            Contrôle0..*
                                            TypeAddress
                                            Est modificateurfalse
                                            Résumétrue
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            254. Patient.maritalStatus
                                            Définition

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

                                            CourtMarital (civil) status of a patient
                                            Contrôle0..1
                                            BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Marital Status Codes
                                            (extensible to http://hl7.org/fhir/ValueSet/marital-status|4.0.1)

                                            The domestic partnership status of a person.

                                            TypeCodeableConcept
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

                                            Most, if not all systems capture it.

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

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

                                            CourtWhether patient is part of a multiple birth
                                            Commentaires

                                            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).

                                            Contrôle0..1
                                            TypeChoix de : boolean, integer
                                            Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résuméfalse
                                            Exigences

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

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

                                            Image of the patient.

                                            CourtImage of the patient
                                            Commentaires

                                            Guidelines:

                                            • Use id photos, not clinical photos.
                                            • Limit dimensions to thumbnail.
                                            • Keep byte count low to ease resource updates.
                                            Contrôle0..*
                                            TypeAttachment
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            260. Patient.contact
                                            Définition

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

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

                                            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.

                                            Contrôle0..*
                                            TypeBackboneElement
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

                                            Need to track people you can contact about the patient.

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

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

                                            CourtUnique id for inter-element referencing
                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                            Résuméfalse
                                            264. Patient.contact.extension
                                            Définition

                                            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.

                                            CourtAdditional content defined by implementations
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurfalse
                                            Résuméfalse
                                            Noms alternatifsextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            266. Patient.contact.modifierExtension
                                            Définition

                                            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).

                                            CourtExtensions that cannot be ignored even if unrecognized
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Résumétrue
                                            Exigences

                                            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.

                                            Noms alternatifsextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            268. Patient.contact.relationship
                                            Définition

                                            The nature of the relationship between the patient and the contact person.

                                            CourtThe kind of relationship
                                            Contrôle0..*
                                            BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de PatientContactRelationship
                                            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

                                            The nature of the relationship between a patient and a contact person for that patient.

                                            TypeCodeableConcept
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            270. Patient.contact.name
                                            Définition

                                            A name associated with the contact person.

                                            CourtA name associated with the contact person
                                            Contrôle0..1
                                            TypeHumanName
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

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

                                            A contact detail for the person, e.g. a telephone number or an email address.

                                            CourtA contact detail for the person
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeContactPoint
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

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

                                            Address for the contact person.

                                            CourtAddress for the contact person
                                            Contrôle0..1
                                            TypeAddress
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            276. Patient.contact.gender
                                            Définition

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

                                            Courtmale | female | other | unknown
                                            Contrôle0..1
                                            BindingLes codes DOIVENT (SHALL) être pris de AdministrativeGender
                                            (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                            The gender of a person used for administrative purposes.

                                            Typecode
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résuméfalse
                                            Exigences

                                            Needed to address the person correctly.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            278. Patient.contact.organization
                                            Définition

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

                                            CourtOrganization that is associated with the contact
                                            Contrôle0..1
                                            Cet élément est affecté par les invariants suivants : pat-1
                                            TypeReference(Organization)
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            280. Patient.contact.period
                                            Définition

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

                                            CourtThe period during which this contact person or organization is valid to be contacted relating to this patient
                                            Contrôle0..1
                                            TypePeriod
                                            Est modificateurfalse
                                            Résuméfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            282. Patient.communication
                                            Définition

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

                                            CourtA language which may be used to communicate with the patient about his or her health
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeBackboneElement
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            284. Patient.communication.id
                                            Définition

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

                                            CourtUnique id for inter-element referencing
                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                            Résuméfalse
                                            286. Patient.communication.extension
                                            Définition

                                            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.

                                            CourtAdditional content defined by implementations
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurfalse
                                            Résuméfalse
                                            Noms alternatifsextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            288. Patient.communication.modifierExtension
                                            Définition

                                            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).

                                            CourtExtensions that cannot be ignored even if unrecognized
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Résumétrue
                                            Exigences

                                            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.

                                            Noms alternatifsextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            290. Patient.communication.language
                                            Définition

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

                                            CourtThe language which can be used to communicate with the patient about his or her health
                                            Commentaires

                                            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.

                                            Contrôle1..1
                                            BindingLes codes DEVRAIENT (SHOULD) être pris de CommonLanguages
                                            (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                            A human language.

                                            Bindings AdditionnelsBut
                                            AllLanguagesBinding Max
                                            TypeCodeableConcept
                                            Est modificateurfalse
                                            Résuméfalse
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            292. Patient.communication.preferred
                                            Définition

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

                                            CourtLanguage preference indicator
                                            Commentaires

                                            This language is specifically identified for communicating healthcare information.

                                            Contrôle0..1
                                            Typeboolean
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résuméfalse
                                            Exigences

                                            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.

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

                                            Patient's nominated care provider.

                                            CourtPatient's nominated primary care provider
                                            Commentaires

                                            This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

                                            Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

                                            Contrôle0..*
                                            TypeReference(Organization, Practitioner, PractitionerRole)
                                            Est modificateurfalse
                                            Résuméfalse
                                            Noms alternatifscareProvider
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            296. Patient.managingOrganization
                                            Définition

                                            Organization that is the custodian of the patient record.

                                            CourtOrganization that is the custodian of the patient record
                                            Commentaires

                                            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).

                                            Contrôle0..1
                                            TypeReference(Organization)
                                            Est modificateurfalse
                                            Résumétrue
                                            Exigences

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            298. Patient.link
                                            Définition

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

                                            CourtLink to another patient resource that concerns the same actual person
                                            Commentaires

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

                                            Contrôle0..*
                                            TypeBackboneElement
                                            Est modificateurtrue parce que 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'
                                            Résumétrue
                                            Exigences

                                            There are multiple use cases:

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

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

                                            CourtUnique id for inter-element referencing
                                            Contrôle0..1
                                            Typestring
                                            Est modificateurfalse
                                            Format XMLDans le format XML, cette propriété est représentée comme attribut.
                                            Résuméfalse
                                            302. Patient.link.extension
                                            Définition

                                            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.

                                            CourtAdditional content defined by implementations
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurfalse
                                            Résuméfalse
                                            Noms alternatifsextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            304. Patient.link.modifierExtension
                                            Définition

                                            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).

                                            CourtExtensions that cannot be ignored even if unrecognized
                                            Commentaires

                                            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.

                                            Contrôle0..*
                                            TypeExtension
                                            Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Résumétrue
                                            Exigences

                                            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.

                                            Noms alternatifsextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            306. Patient.link.other
                                            Définition

                                            The other patient resource that the link refers to.

                                            CourtThe other patient or related person resource that the link refers to
                                            Commentaires

                                            Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                                            Contrôle1..1
                                            TypeReference(Patient, RelatedPerson)
                                            Est modificateurfalse
                                            Résumétrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            308. Patient.link.type
                                            Définition

                                            The type of link between this patient resource and another patient resource.

                                            Courtreplaced-by | replaces | refer | seealso
                                            Contrôle1..1
                                            BindingLes codes DOIVENT (SHALL) être pris de LinkType
                                            (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

                                            The type of link between this patient resource and another patient resource.

                                            Typecode
                                            Est modificateurfalse
                                            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
                                            Résumétrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))