# Clinical Note Document

26.0.0 AU

Clinical Note Document - Local Development build (v26.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Extension: Informal Carer

Official URL: http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer | Version: 26.0.0
Active as of 2026-06-19 | Computable Name: InformalCarer
Copyright/Legal: This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/

This extension can be used to represent information about an informal carer of a patient. An informal carer includes any person, such as a family member, friend or neighbour, who is giving regular, ongoing assistance to another person. This may provide healthcare providers with additional information on the patients support system and identified contact person. The definition for the patient’s informal carer existence indicator is the same described in the definition section of the NMDS. Additionally, this extension allows for the representation of the carer information.

This extension supports the capture of informal carer information for a patient in a Clinical Note Document context, enabling healthcare providers to record the existence and details of informal carers such as family members, friends, or neighbours who provide regular ongoing assistance, in alignment with the AIHW NMDS informal carer existence indicator definition.

Context of Use

This extension may be used on the following element(s)

- Element ID: `Patient`

Usage info

Usages:

- Use this Extension: CND Patient
- Examples for this Extension: Bundle/ex-bundle-anne, Patient/ex-patient-anne and Patient/ex-patient-smith

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Informal Carer Constraints: inv-01-carer-indicator-error, inv-02-carer-indicator-warning
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator | S | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | CodeableConcept | Informal carer existence indicator Binding: Informal Carer Existence Indicator (required)
extension:carer | S | 0..* | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "carer"
value[x] |  | 1..1 | Reference(AU Base RelatedPerson) | Informal carer details
url |  | 1..1 | uri | "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Informal Carer Constraints: inv-01-carer-indicator-error, inv-02-carer-indicator-warning
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:indicator | S | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | CodeableConcept | Informal carer existence indicator Binding: Informal Carer Existence Indicator (required)
extension:carer | S | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "carer"
value[x] |  | 1..1 | Reference(AU Base RelatedPerson) | Informal carer details
url |  | 1..1 | uri | "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension can be used to represent information about an informal carer of a patient. An informal carer includes any person, such as a family member, friend or neighbour, who is giving regular, ongoing assistance to another person. This may provide healthcare providers with additional information on the patients support system and identified contact person. The definition for the patient’s informal carer existence indicator is the same described in the definition section of the NMDS. Additionally, this extension allows for the representation of the carer information.

- indicator: CodeableConcept: An Extension
- carer: Reference: An Extension

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Informal Carer Constraints: inv-01-carer-indicator-error, inv-02-carer-indicator-warning
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator | S | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | CodeableConcept | Informal carer existence indicator Binding: Informal Carer Existence Indicator (required)
extension:carer | S | 0..* | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "carer"
value[x] |  | 1..1 | Reference(AU Base RelatedPerson) | Informal carer details
url |  | 1..1 | uri | "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Informal Carer Constraints: inv-01-carer-indicator-error, inv-02-carer-indicator-warning
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:indicator | S | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | CodeableConcept | Informal carer existence indicator Binding: Informal Carer Existence Indicator (required)
extension:carer | S | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "carer"
value[x] |  | 1..1 | Reference(AU Base RelatedPerson) | Informal carer details
url |  | 1..1 | uri | "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension can be used to represent information about an informal carer of a patient. An informal carer includes any person, such as a family member, friend or neighbour, who is giving regular, ongoing assistance to another person. This may provide healthcare providers with additional information on the patients support system and identified contact person. The definition for the patient’s informal carer existence indicator is the same described in the definition section of the NMDS. Additionally, this extension allows for the representation of the carer information.

- indicator: CodeableConcept: An Extension
- carer: Reference: An Extension

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:indicator.​value[x] | Base | required | Informal Carer Existence Indicator | 📦26.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
inv-01-carer-indicator-error | error | Extension | If indicator is not 'Yes', then no carers SHALL be provided. | `extension.where(url = 'indicator').value.coding.where(system = 'http://snomed.info/sct' and code = '373066001').empty() implies extension.where(url = 'carer').empty()`
inv-02-carer-indicator-warning | warning | Extension | If indicator is 'Yes', then at least one carer SHOULD be provided. | `extension.where(url = 'indicator').value.coding.where(system = 'http://snomed.info/sct' and code = '373066001').exists() implies extension.where(url = 'carer').value.exists()`