Datatypes-definitions

This element has a standards status of "Normative"

Element Id

Attachment

Definition

For referring to data content defined in other formats.

0..*

Requirements

Many models need to include data defined in other specifications that is complex and opaque to the healthcare model. This includes documents, media recordings, structured data, etc.

Comments

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

Invariants

Defined on this element
att-1	Rule	If the Attachment has data, it SHALL have a contentType	data.empty() or contentType.exists()

Attachment.contentType

Element Id

Attachment.contentType

Definition

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

0..1

Requirements

Processors of the data need to be able to know how to interpret the data.

true

Attachment.language

Element Id

Attachment.language

Definition

The human language of the content. The value can be any valid value according to BCP 47.

0..1

Common Languages (Preferred but limited to All Languages)

Requirements

Users need to be able to choose between the languages in a set of attachments.

true

Attachment.data

Element Id

Attachment.data

Definition

The actual data of the attachment - a sequence of bytes, base64 encoded.

0..1

base64Binary

Requirements

The data needs to able to be transmitted inline.

Comments

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

Attachment.url

Element Id

Attachment.url

Definition

A location where the data can be accessed.

0..1

url

Requirements

The data needs to be transmitted by reference.

true

Comments

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

Attachment.size

Element Id

Attachment.size

Definition

The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

0..1

unsignedInt

Requirements

Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

true

Comments

The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

Attachment.hash

Element Id

Attachment.hash

Definition

The calculated hash of the data using SHA-1. Represented using base64.

0..1

base64Binary

Requirements

Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

true

Comments

The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

Attachment.title

Element Id

Attachment.title

Definition

A label or set of text to display in place of the data.

0..1

string

Requirements

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

true

Attachment.creation

Element Id

Attachment.creation

Definition

The date that the attachment was first created.

0..1

dateTime

Requirements

This is often tracked as an integrity issue for use of the attachment.

true

2.24.2.3 Identifier

Identifier
Standards Status	This element has a standards status of "Normative"
Element Id	Identifier
Definition	An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality	0..*
Type	Element
Requirements	Need to be able to identify things with confidence and be sure that the identification is not subject to misinterpretation.
Summary	true
Identifier.use
Element Id	Identifier.use
Definition	The purpose of this identifier.
Cardinality	0..1
Terminology Binding	IdentifierUse (Required)
Type	code
Is Modifier	true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.)
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Summary	true
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Identifier.type
Element Id	Identifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality	0..1
Terminology Binding	IdentifierType (Extensible)
Type	CodeableConcept
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Summary	true
Comments	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.
Identifier.system
Element Id	Identifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality	0..1
Type	uri
Requirements	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.
Summary	true
Comments	Identifier.system is always case sensitive.
Identifier.value
Element Id	Identifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality	0..1
Type	string
Summary	true
Comments	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.
Identifier.period
Element Id	Identifier.period
Definition	Time period during which identifier is/was valid for use.
Cardinality	0..1
Type	Period
Summary	true
Identifier.assigner
Element Id	Identifier.assigner
Definition	Organization that issued/manages the identifier.
Cardinality	0..1
Type	Reference(Organization)
Summary	true
Comments	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.

2.24.2.4 Coding

Coding
Standards Status	This element has a standards status of "Normative"
Element Id	Coding
Definition	A reference to a code defined by a terminology system.
Cardinality	0..*
Type	Element
Requirements	References to codes are very common in healthcare models.
Summary	true
Comments	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.
Coding.system
Element Id	Coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	0..1
Type	uri
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Summary	true
Comments	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.
Coding.version
Element Id	Coding.version
Definition	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.
Note	This is a business versionId, not a resource version id (see discussion)
Cardinality	0..1
Type	string
Summary	true
Comments	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.
Coding.code
Element Id	Coding.code
Definition	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).
Cardinality	0..1
Type	code
Requirements	Need to refer to a particular code in the system.
Summary	true
Coding.display
Element Id	Coding.display
Definition	A representation of the meaning of the code in the system, following the rules of the system.
Cardinality	0..1
Type	string
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary	true
Coding.userSelected
Element Id	Coding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0..1
Type	boolean
Requirements	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.
Summary	true
Comments	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.

2.24.2.5 CodeableConcept

CodeableConcept
Standards Status	This element has a standards status of "Normative"
Element Id	CodeableConcept
Definition	A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Cardinality	0..*
Type	Element
Requirements	This is a common pattern in healthcare - a concept that may be defined by one or more codes from formal definitions including LOINC and SNOMED CT, and/or defined by the provision of text that captures a human sense of the concept.
Summary	true
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
CodeableConcept.coding
Element Id	CodeableConcept.coding
Definition	A reference to a code defined by a terminology system.
Cardinality	0..*
Type	Coding
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Summary	true
Comments	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.
CodeableConcept.text
Element Id	CodeableConcept.text
Definition	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.
Cardinality	0..1
Type	string
Requirements	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.
Summary	true
Comments	Very often the text is the same as a displayName of one of the codings.

2.24.2.6 Quantity

Quantity

This element has a standards status of "Normative"

Element Id

Quantity

Definition

A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies.

0..*

Requirements

Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.

true

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants

Defined on this element
qty-3	Rule	If a code for the unit is present, the system SHALL also be present	code.empty() or system.exists()

Quantity.value

Element Id

Quantity.value

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

0..1

decimal

Requirements

Precision is handled implicitly in almost all cases of measurement.

true

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Quantity.comparator

Element Id

Quantity.comparator

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

0..1

QuantityComparator (Required)

Is Modifier

true (Reason: This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value)

Meaning if Missing

If there is no comparator, then there is no modification of the value

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

true

Quantity.unit

Element Id

Quantity.unit

Definition

A human-readable form of the unit.

0..1

string

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

true

Quantity.system

Element Id

Quantity.system

Definition

The identification of the system that provides the coded form of the unit.

0..1

uri

Requirements

Need to know the system that defines the coded form of the unit.

true

Invariants

Affect this element
qty-3	Rule	If a code for the unit is present, the system SHALL also be present	code.empty() or system.exists()

Quantity.code

Element Id

Quantity.code

Definition

A computer processable form of the unit in some unit representation system.

0..1

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

true

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

2.24.2.7 Money

Money
Standards Status	This element has a standards status of "Normative"
Element Id	Money
Definition	An amount of economic utility in some recognized currency.
Cardinality	0..*
Type	Element
Summary	true
Money.value
Element Id	Money.value
Definition	Numerical value (with implicit precision).
Cardinality	0..1
Type	decimal
Requirements	The amount of the currency. The value includes an implicit precision in the presentation of the value.
Summary	true
Comments	Monetary values have their own rules for handling precision (refer to standard accounting text books).
Money.currency
Element Id	Money.currency
Definition	ISO 4217 Currency Code.
Cardinality	0..1
Terminology Binding	CurrencyCode (Required)
Type	code
Requirements	A code indicating the currency, taken from ISO 4217.
Summary	true

2.24.2.8 Range

Range

This element has a standards status of "Normative"

Element Id

Range

Definition

A set of ordered Quantities defined by a low and high limit.

0..*

Requirements

Need to be able to specify ranges of values.

true

Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Invariants

Defined on this element
rng-2	Rule	If present, low SHALL have a lower value than high	low.empty() or high.empty() or (low <= high)

Range.low

Element Id

Range.low

Definition

The low limit. The boundary is inclusive.

0..1

true

Comments

If the low element is missing, the low boundary is not known.

Range.high

Element Id

Range.high

Definition

The high limit. The boundary is inclusive.

0..1

true

Comments

If the high element is missing, the high boundary is not known.

2.24.2.9 Ratio

Ratio

This element has a standards status of "Normative"

Element Id

Ratio

Definition

A relationship of two Quantity values - expressed as a numerator and a denominator.

0..*

Requirements

Need to able to capture ratios for some measurements (titers) and some rates (costs).

true

Comments

The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

Invariants

Defined on this element
rat-1	Rule	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present	(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Ratio.numerator

Element Id

Ratio.numerator

Definition

The value of the numerator.

0..1

true

Ratio.denominator

Element Id

Ratio.denominator

Definition

The value of the denominator.

0..1

true

2.24.2.10 Period

Period

This element has a standards status of "Normative"

Element Id

Period

Definition

A time period defined by a start and end date and optionally time.

0..*

true

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants

Defined on this element
per-1	Rule	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)

Period.start

Element Id

Period.start

Definition

The start of the period. The boundary is inclusive.

0..1

true

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants

Affect this element
per-1	Rule	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)

Period.end

Element Id

Period.end

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

0..1

dateTime

Meaning if Missing

If the end of the period is missing, it means that the period is ongoing

true

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Invariants

Affect this element
per-1	Rule	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)

2.24.2.11 SampledData

Normative Candidate Note: This DataType is not normative - it is still undergoing Trial Use while more experience is gathered.

SampledData
Standards Status	This element has a standards status of "Trial Use"
Element Id	SampledData
Definition	A series of measurements taken by a device, with upper and lower limits. There may be more than one dimension in the data.
Cardinality	0..*
Type	Element
Requirements	There is a need for a concise way to handle the data produced by devices that sample a physical state at a high frequency.
Comments	The data is not interpretable without at least origin, period, and dimensions, but these are optional to allow a separation between the template of measurement and the actual measurement, such as between DeviceCapabilities and DeviceLog. When providing a summary view (for example with Observation.value[x]) SampledData should be represented with a brief display text such as "Sampled Data".
SampledData.origin
Element Id	SampledData.origin
Definition	The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.
Cardinality	1..1
Type	SimpleQuantity
Summary	true
SampledData.period
Element Id	SampledData.period
Definition	The length of time between sampling times, measured in milliseconds.
Cardinality	1..1
Type	decimal
Summary	true
Comments	This is usually a whole number.
SampledData.factor
Element Id	SampledData.factor
Definition	A correction factor that is applied to the sampled data points before they are added to the origin.
Cardinality	0..1
Type	decimal
Meaning if Missing	If no factor is assigned, the data is not adjusted before adding to the origin
Summary	true
SampledData.lowerLimit
Element Id	SampledData.lowerLimit
Definition	The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit).
Cardinality	0..1
Type	decimal
Summary	true
SampledData.upperLimit
Element Id	SampledData.upperLimit
Definition	The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit).
Cardinality	0..1
Type	decimal
Summary	true
SampledData.dimensions
Element Id	SampledData.dimensions
Definition	The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.
Cardinality	1..1
Type	positiveInt
Summary	true
Comments	If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).
SampledData.data
Element Id	SampledData.data
Definition	A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.
Cardinality	0..1
Type	string
Comments	Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

2.24.2.12 HumanName

HumanName
Standards Status	This element has a standards status of "Normative"
Element Id	HumanName
Definition	A human's name with the ability to identify parts and usage.
Cardinality	0..*
Type	Element
Requirements	Need to be able to record names, along with notes about their use.
Summary	true
Comments	Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
HumanName.use
Element Id	HumanName.use
Definition	Identifies the purpose for this name.
Cardinality	0..1
Terminology Binding	NameUse (Required)
Type	code
Is Modifier	true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one)
Requirements	Allows the appropriate name for a particular context of use to be selected from among a set of names.
Summary	true
Comments	Applications can assume that a name is current unless it explicitly says that it is temporary or old.
HumanName.text
Element Id	HumanName.text
Definition	Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
Cardinality	0..1
Type	string
Requirements	A renderable, unencoded form.
Summary	true
Comments	Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
HumanName.family
Element Id	HumanName.family
Definition	The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Cardinality	0..1
Type	string
Alternate Names	surname
Summary	true
Comments	Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
HumanName.given
Element Id	HumanName.given
Definition	Given name.
Cardinality	0..*
Type	string
Element Order Meaning	Given Names appear in the correct order for presenting the name
Alternate Names	first name; middle name
Summary	true
Comments	If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
HumanName.prefix
Element Id	HumanName.prefix
Definition	Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.
Cardinality	0..*
Type	string
Element Order Meaning	Prefixes appear in the correct order for presenting the name
Summary	true
HumanName.suffix
Element Id	HumanName.suffix
Definition	Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.
Cardinality	0..*
Type	string
Element Order Meaning	Suffixes appear in the correct order for presenting the name
Summary	true
HumanName.period
Element Id	HumanName.period
Definition	Indicates the period of time when this name was valid for the named person.
Cardinality	0..1
Type	Period
Requirements	Allows names to be placed in historical context.
Summary	true

2.24.2.13 Address

Address
Standards Status	This element has a standards status of "Normative"
Element Id	Address
Definition	An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.
Cardinality	0..*
Type	Element
Requirements	Need to be able to record postal addresses, along with notes about their use.
Summary	true
Comments	Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Address.use
Element Id	Address.use
Definition	The purpose of this address.
Cardinality	0..1
Terminology Binding	AddressUse (Required)
Type	code
Is Modifier	true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one)
Requirements	Allows an appropriate address to be chosen from a list of many.
Summary	true
Comments	Applications can assume that an address is current unless it explicitly says that it is temporary or old.
Address.type
Element Id	Address.type
Definition	Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
Cardinality	0..1
Terminology Binding	AddressType (Required)
Type	code
Summary	true
Comments	The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
Address.text
Element Id	Address.text
Definition	Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
Cardinality	0..1
Type	string
Requirements	A renderable, unencoded form.
Summary	true
Comments	Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
Address.line
Element Id	Address.line
Definition	This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Cardinality	0..*
Type	string
Element Order Meaning	The order in which lines should appear in an address label
Summary	true
Address.city
Element Id	Address.city
Definition	The name of the city, town, suburb, village or other community or delivery center.
Cardinality	0..1
Type	string
Alternate Names	Municpality
Summary	true
Address.district
Element Id	Address.district
Definition	The name of the administrative area (county).
Cardinality	0..1
Type	string
Alternate Names	County
Summary	true
Comments	District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
Address.state
Element Id	Address.state
Definition	Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
Cardinality	0..1
Type	string
Alternate Names	Province; Territory
Summary	true
Address.postalCode
Element Id	Address.postalCode
Definition	A postal code designating a region defined by the postal service.
Cardinality	0..1
Type	string
Alternate Names	Zip
Summary	true
Address.country
Element Id	Address.country
Definition	Country - a nation as commonly understood or generally accepted.
Cardinality	0..1
Type	string
Summary	true
Comments	ISO 3166 3 letter codes can be used in place of a human readable country name.
Address.period
Element Id	Address.period
Definition	Time period when address was/is in use.
Cardinality	0..1
Type	Period
Requirements	Allows addresses to be placed in historical context.
Summary	true

2.24.2.14 ContactPoint

ContactPoint

This element has a standards status of "Normative"

Element Id

ContactPoint

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

0..*

Requirements

Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.

true

Invariants

Defined on this element
cpt-2	Rule	A system is required if a value is provided.	value.empty() or system.exists()

ContactPoint.system

Element Id

ContactPoint.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

0..1

ContactPointSystem (Required)

true

Invariants

Affect this element
cpt-2	Rule	A system is required if a value is provided.	value.empty() or system.exists()

ContactPoint.value

Element Id

ContactPoint.value

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

0..1

string

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

true

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

ContactPoint.use

Element Id

ContactPoint.use

Definition

Identifies the purpose for the contact point.

0..1

ContactPointUse (Required)

Is Modifier

true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one)

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

true

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

ContactPoint.rank

Element Id

ContactPoint.rank

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

0..1

true

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

ContactPoint.period

Element Id

ContactPoint.period

Definition

Time period when the contact point was/is in use.

0..1

true

2.24.2.15 Timing

Timing

This element has a standards status of "Normative"

Element Id

Timing

Definition

Specifies an event that may occur multiple times. Timing schedules are used to record when things are planned, expected or requested to occur. The most common usage is in dosage instructions for medications. They are also used when planning care of various kinds, and may be used for reporting the schedule to which past regular activities were carried out.

0..*

BackboneElement

Requirements

Need to able to track proposed timing schedules. There are several different ways to do this: one or more specified times, a simple rules like three times a day, or before/after meals.

true

Comments

Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.

Timing.event

Element Id

Timing.event

Definition

Identifies specific times when the event occurs.

0..*

dateTime

Requirements

In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

true

Timing.repeat

Element Id

Timing.repeat

Definition

A set of rules that describe when the event is scheduled.

0..1

Requirements

Many timing schedules are determined by regular repetitions.

true

Invariants

Defined on this element
tim-1	Rule	if there's a duration, there needs to be duration units	duration.empty() or durationUnit.exists()
tim-2	Rule	if there's a period, there needs to be period units	period.empty() or periodUnit.exists()
tim-4	Rule	duration SHALL be a non-negative value	duration.exists() implies duration >= 0
tim-5	Rule	period SHALL be a non-negative value	period.exists() implies period >= 0
tim-6	Rule	If there's a periodMax, there must be a period	periodMax.empty() or period.exists()
tim-7	Rule	If there's a durationMax, there must be a duration	durationMax.empty() or duration.exists()
tim-8	Rule	If there's a countMax, there must be a count	countMax.empty() or count.exists()
tim-9	Rule	If there's an offset, there must be a when (and not C, CM, CD, CV)	offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))
tim-10	Rule	If there's a timeOfDay, there cannot be a when, or vice versa	timeOfDay.empty() or when.empty()

Timing.repeat.bounds[x]

Element Id

Timing.repeat.bounds[x]

Definition

Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

0..1

Duration|Range|Period

[x] Note

See Choice of Data Types for further information about how to use [x]

true

Timing.repeat.count

Element Id

Timing.repeat.count

Definition

A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

0..1

positiveInt

Requirements

Repetitions may be limited by end time or total occurrences.

true

Comments

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

Timing.repeat.countMax

Element Id

Timing.repeat.countMax

Definition

If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

0..1

true

Timing.repeat.duration

Element Id

Timing.repeat.duration

Definition

How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

0..1

decimal

Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

true

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

Timing.repeat.durationMax

Element Id

Timing.repeat.durationMax

Definition

If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

0..1

decimal

Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

true

Comments

Timing.repeat.durationUnit

Element Id

Timing.repeat.durationUnit

Definition

The units of time for the duration, in UCUM units.

0..1

UnitsOfTime (Required)

true

Timing.repeat.frequency

Element Id

Timing.repeat.frequency

Definition

The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

0..1

positiveInt

Meaning if Missing

If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this

true

Timing.repeat.frequencyMax

Element Id

Timing.repeat.frequencyMax

Definition

If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

0..1

true

Timing.repeat.period

Element Id

Timing.repeat.period

Definition

Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

0..1

true

Timing.repeat.periodMax

Element Id

Timing.repeat.periodMax

Definition

If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

0..1

true

Timing.repeat.periodUnit

Element Id

Timing.repeat.periodUnit

Definition

The units of time for the period in UCUM units.

0..1

UnitsOfTime (Required)

true

Timing.repeat.dayOfWeek

Element Id

Timing.repeat.dayOfWeek

Definition

If one or more days of week is provided, then the action happens only on the specified day(s).

0..*

DaysOfWeek (Required)

true

Comments

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

Timing.repeat.timeOfDay

Element Id

Timing.repeat.timeOfDay

Definition

Specified time of day for action to take place.

0..*

true

Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

Timing.repeat.when

Element Id

Timing.repeat.when

Definition

An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

0..*

EventTiming (Required)

Requirements

Timings are frequently determined by occurrences such as waking, eating and sleep.

true

Comments

When more than one event is listed, the event is tied to the union of the specified events.

Timing.repeat.offset

Element Id

Timing.repeat.offset

Definition

The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

0..1

true

Timing.code

Element Id

Timing.code

Definition

A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

0..1

TimingAbbreviation (Preferred)

CodeableConcept