# 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: InformalCarer - Detailed Descriptions

Active as of 2026-06-19

Definitions for the informal-carer extension.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Extension
Definition | 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. Optional Extension Element - found in all resources.
Short | Informal CarerOptional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Is Modifier | false
Invariants | 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()`) inv-01-carer-indicator-error: 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: 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
2. Extension.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. Extension.extension:indicator
Slice Name | indicator
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 10..1*
Type | Extension
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
6. Extension.extension:indicator.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. Extension.extension:indicator.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `indicator`
10. Extension.extension:indicator.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Informal carer existence indicatorValue of extension
Control | 10..1
Binding | The codes SHALL be taken from For codes, see Informal Carer Existence Indicator (required to `http://digitalhealth.gov.au/fhir/cnd/ValueSet/informal-carer-existence-indicator-vs` )
Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Extension.extension:carer
Slice Name | carer
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..*
Type | Extension
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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. Extension.extension:carer.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Extension.extension:carer.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `carer`
18. Extension.extension:carer.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Informal carer detailsValue of extension
Control | 10..1
Type | Reference(AU Base RelatedPerson), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Extension.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer`
22. Extension.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..01
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Extension
Definition | 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.
Short | Informal Carer
Invariants | inv-01-carer-indicator-error: 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: 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()`)
2. Extension.extension
Control | 1..?
4. Extension.extension:indicator
Slice Name | indicator
Control | 1..1
Must Support | true
6. Extension.extension:indicator.extension
Control | 0..0
8. Extension.extension:indicator.url
Fixed Value | `indicator`
10. Extension.extension:indicator.value[x]
Short | Informal carer existence indicator
Control | 1..?
Binding | The codes SHALL be taken from Informal Carer Existence Indicator (required to `http://digitalhealth.gov.au/fhir/cnd/ValueSet/informal-carer-existence-indicator-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
12. Extension.extension:carer
Slice Name | carer
Control | 0..*
Must Support | true
14. Extension.extension:carer.extension
Control | 0..0
16. Extension.extension:carer.url
Fixed Value | `carer`
18. Extension.extension:carer.value[x]
Short | Informal carer details
Control | 1..?
Type | Reference(AU Base RelatedPerson)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
20. Extension.url
Fixed Value | `http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer`
22. Extension.value[x]
Control | 0..0

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

0. Extension
Definition | 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.
Short | Informal Carer
Control | 0..* This element is affected by the following invariants: ele-1
Is Modifier | false
Invariants | 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()`) inv-01-carer-indicator-error: 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: 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()`)
2. Extension.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
4. Extension.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Extension.extension:indicator
Slice Name | indicator
Definition | An Extension
Short | Extension
Control | 1..1
Type | Extension
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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. Extension.extension:indicator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
10. Extension.extension:indicator.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
12. Extension.extension:indicator.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `indicator`
14. Extension.extension:indicator.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Informal carer existence indicator
Control | 1..1
Binding | The codes SHALL be taken from Informal Carer Existence Indicator (required to `http://digitalhealth.gov.au/fhir/cnd/ValueSet/informal-carer-existence-indicator-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. Extension.extension:carer
Slice Name | carer
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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. Extension.extension:carer.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
20. Extension.extension:carer.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. Extension.extension:carer.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `carer`
24. Extension.extension:carer.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Informal carer details
Control | 1..1
Type | Reference(AU Base RelatedPerson)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Extension.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/informal-carer`
28. Extension.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..0
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)