| Australian Digital Health Agency FHIR Implementation Guide 1.0.0

Australian Digital Health Agency FHIR Implementation Guide. This is the current published version. It is based on FHIR® version 4.0.1. See the Directory of published versions for a list of available versions.

### StructureDefinition: ADHA Core Patient [Active]

The purpose of this profile is to provide a core representation of a patient for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia. This profile supports Cultural and Linguistic Diversity (CALD) data set [1] [2], including country of birth, year of arrival and preferred language.

This profile identifies the additional constraints, extensions, and value sets that build on and extend Patient that are supported.

This profile is designed to set a core Patient standard for:

- Querying for records associated with a patient
- Record or update a record associated with a patient

#### Profile specific guidance

- Country of birth is represented using `Patient.extension` birthPlace extension
  - A system may use `address.text` if birth place address is not stored in discrete elements
- See the Representing communication preferences section for guidance
- A patient’s biological sex is represented as a separate Observation resource

#### Boundaries and relationships

This profile is referenced by ADHA Core BodyStructure, ADHA Organ or Tissue for Donation BodyStructure, ADHA Core Condition, ADHA Record of Consent from Australian Organ Donor Register, ADHA Core DocumentReference, ADHA Core Encounter, ADHA Record of Claim against MBS or DVA, ADHA Record of Claim against PBS or RPBS, ADHA Australian Immunisation Register Notice, ADHA Core Flag, ADHA Record of Immunisation from Australian Immunisation Register, ADHA Core Immunization, ADHA Core MedicationRequest, ADHA PBS Claim Item, ADHA Core Observation, ADHA Core Procedure, ADHA Authoring RelatedPerson, and ADHA Core RelatedPerson.

#### Formal Views of Profile Content

The official URL for this profile is:

    http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-core-1

The purpose of this profile is to provide a core representation of a patient for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia.

This profile builds on AUBasePatient.

This profile was published on 2023-04-14 04:02:01+0000 as a active by Australian Digital Health Agency.

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

- Differential Table
- Snapshot Table
- All

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | C | 0..* | AUBasePatient | A patient in the context of electronic exchange of health information inv-dh-pat-01: At least one patient identifier shall be valid inv-dh-pat-02: At least one patient name shall have a family name inv-dh-pat-03: If present, a general practitioner shall at least have a reference, an identifier or a display
extension:birthPlace | S | 0..1 | birthPlace | Place of Birth for patient
extension:indigenousStatus | S | 0..1 | AustralianIndigenousStatus | Indigenous status
extension:interpreterRequired | S | 0..1 | interpreterRequired | Whether the patient needs an interpreter
extension:dateOfArrival | S | 0..1 | DateOfArrivalAustralia | Year of Arrival
Slices for identifier | S C | 1..* | Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber | Identifies this patient across multiple systems Slice: Unordered, Open by pattern:type
identifier:ihi | S | 0..1 | AUIHI | Individual Healthcare Identifier (IHI)
identifier:medicare | S | 0..1 | AUMedicareCardNumber | Medicare Card Number
identifier:dva | S | 0..1 | AUDVANumber | Department of Veterans' Affairs (DVA) Number
active |  | 0..1 | boolean | Whether this patient's record is in active use Fixed Value: true
name | S C | 1..* | HumanName | A name associated with the patient inv-dh-pat-04: At least text, family name, or given name shall be present
telecom | S | 0..* | ContactPoint | A contact detail for the individual
gender | S | 1..1 | code | male | female | other | unknown
birthDate | S | 1..1 | date | Date of birth extended for time and accuracy indicator
extension:accuracyIndicator | S | 0..1 | DateAccuracyIndicator | Date accuracy indicator
extension:birthTime | S | 0..1 | birthTime | Time of day of birth
address | S | 0..* | AustralianAddress, Address | An address for the individual
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health
preferred | S | 0..1 | boolean | Language preference indicator
generalPractitioner | S C | 0..* | Reference(ADHA Core Organization | ADHA Core PractitionerRole) | Patient's nominated primary care provider
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | C | 0..* | AUBasePatient | A patient in the context of electronic exchange of health information inv-dh-pat-01: At least one patient identifier shall be valid inv-dh-pat-02: At least one patient name shall have a family name inv-dh-pat-03: If present, a general practitioner shall at least have a reference, an identifier or a display
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
birthPlace | S | 0..1 | Address | Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus | S | 0..1 | Coding | Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration |  | 0..1 | boolean | Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName |  | 0..1 | string | Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired | S | 0..1 | boolean | Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival | S | 0..1 | date | Year of Arrival URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S C | 1..* | Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber | Identifies this patient across multiple systems Slice: Unordered, Open by pattern:type
identifier:ihi | S C | 0..1 | AUIHI | Individual Healthcare Identifier (IHI)
identifier:medicare | S | 0..1 | AUMedicareCardNumber | Medicare Card Number
identifier:dva | S | 0..1 | AUDVANumber | Department of Veterans' Affairs (DVA) Number
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use Fixed Value: true
name | S Σ C | 1..* | HumanName | A name associated with the patient inv-dh-pat-04: At least text, family name, or given name shall be present
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | S Σ | 1..1 | date | Date of birth extended for time and accuracy indicator
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
accuracyIndicator | S | 0..1 | Coding | Date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime | S | 0..1 | dateTime | Time of day of birth URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
value |  | 0..1 | date | Primitive value for date
Slices for deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
deceased[x]:deceasedBoolean | ?!Σ | 0..1 | boolean | Deceased indicator
deceased[x]:deceasedDateTime | ?!Σ | 0..1 | dateTime | Deceased date time
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
accuracyIndicator |  | 0..1 | Coding | Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
value |  | 0..1 | dateTime | Primitive value for dateTime
address | S C | 0..* | AustralianAddress, Address | An address for the individual
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address, AustralianAddress | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
preferred | S | 0..1 | boolean | Language preference indicator
generalPractitioner | S C | 0..* | Reference(ADHA Core Organization | ADHA Core PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to a Patient or RelatedPerson resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Differential View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | C | 0..* | AUBasePatient | A patient in the context of electronic exchange of health information inv-dh-pat-01: At least one patient identifier shall be valid inv-dh-pat-02: At least one patient name shall have a family name inv-dh-pat-03: If present, a general practitioner shall at least have a reference, an identifier or a display
extension:birthPlace | S | 0..1 | birthPlace | Place of Birth for patient
extension:indigenousStatus | S | 0..1 | AustralianIndigenousStatus | Indigenous status
extension:interpreterRequired | S | 0..1 | interpreterRequired | Whether the patient needs an interpreter
extension:dateOfArrival | S | 0..1 | DateOfArrivalAustralia | Year of Arrival
Slices for identifier | S C | 1..* | Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber | Identifies this patient across multiple systems Slice: Unordered, Open by pattern:type
identifier:ihi | S | 0..1 | AUIHI | Individual Healthcare Identifier (IHI)
identifier:medicare | S | 0..1 | AUMedicareCardNumber | Medicare Card Number
identifier:dva | S | 0..1 | AUDVANumber | Department of Veterans' Affairs (DVA) Number
active |  | 0..1 | boolean | Whether this patient's record is in active use Fixed Value: true
name | S C | 1..* | HumanName | A name associated with the patient inv-dh-pat-04: At least text, family name, or given name shall be present
telecom | S | 0..* | ContactPoint | A contact detail for the individual
gender | S | 1..1 | code | male | female | other | unknown
birthDate | S | 1..1 | date | Date of birth extended for time and accuracy indicator
extension:accuracyIndicator | S | 0..1 | DateAccuracyIndicator | Date accuracy indicator
extension:birthTime | S | 0..1 | birthTime | Time of day of birth
address | S | 0..* | AustralianAddress, Address | An address for the individual
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health
preferred | S | 0..1 | boolean | Language preference indicator
generalPractitioner | S C | 0..* | Reference(ADHA Core Organization | ADHA Core PractitionerRole) | Patient's nominated primary care provider
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | C | 0..* | AUBasePatient | A patient in the context of electronic exchange of health information inv-dh-pat-01: At least one patient identifier shall be valid inv-dh-pat-02: At least one patient name shall have a family name inv-dh-pat-03: If present, a general practitioner shall at least have a reference, an identifier or a display
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
birthPlace | S | 0..1 | Address | Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus | S | 0..1 | Coding | Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration |  | 0..1 | boolean | Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName |  | 0..1 | string | Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired | S | 0..1 | boolean | Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival | S | 0..1 | date | Year of Arrival URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S C | 1..* | Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber | Identifies this patient across multiple systems Slice: Unordered, Open by pattern:type
identifier:ihi | S C | 0..1 | AUIHI | Individual Healthcare Identifier (IHI)
identifier:medicare | S | 0..1 | AUMedicareCardNumber | Medicare Card Number
identifier:dva | S | 0..1 | AUDVANumber | Department of Veterans' Affairs (DVA) Number
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use Fixed Value: true
name | S Σ C | 1..* | HumanName | A name associated with the patient inv-dh-pat-04: At least text, family name, or given name shall be present
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | S Σ | 1..1 | date | Date of birth extended for time and accuracy indicator
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
accuracyIndicator | S | 0..1 | Coding | Date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime | S | 0..1 | dateTime | Time of day of birth URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
value |  | 0..1 | date | Primitive value for date
Slices for deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
deceased[x]:deceasedBoolean | ?!Σ | 0..1 | boolean | Deceased indicator
deceased[x]:deceasedDateTime | ?!Σ | 0..1 | dateTime | Deceased date time
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
accuracyIndicator |  | 0..1 | Coding | Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
value |  | 0..1 | dateTime | Primitive value for dateTime
address | S C | 0..* | AustralianAddress, Address | An address for the individual
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address, AustralianAddress | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
preferred | S | 0..1 | boolean | Language preference indicator
generalPractitioner | S C | 0..* | Reference(ADHA Core Organization | ADHA Core PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to a Patient or RelatedPerson resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
Patient.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
Patient.gender | required | AdministrativeGender
Patient.maritalStatus | extensible | Marital Status Codes
Patient.contact.relationship | extensible | https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3
Patient.contact.gender | required | AdministrativeGender
Patient.communication.language | extensible | https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2
Patient.link.type | required | LinkType

#### Search Parameters

None defined.