Patient Profile

Canonical	../StructureDefinition/nexus-emr-core-patient
Status	draft · 1.26.0
Base	Patient (constraint)
Source	FSH · JSON

Generic Nexus EMR core profile for patient demographic and administrative information, based on CA Core+. Designed to support a broad range of integration needs.

Examples

Alice Johnson (referral scenario) · Avery Linwood · David Chen (post-discharge scenario) · Jennifer Martinez (diabetes education scenario) · John Doe (lab review scenario) · John smith alberta · Maria Gonzalez (AI triage scenario) · Not Enrolled (decided negative) · Seen Fee-for-Service · With Indigenous Profile Fields · With No Health Card (identity surface) · With Primary Care Attachment

With No Health Card (identity surface)

Patient with no provincial health card, carrying Ontario's CA-eReC reason-for-no-HCN extension on the MRN identifier, plus genderIdentity and pronouns in their correct COMPLEX form (value sub-extension) and the required address.state / address.country bindings. The worked example for the identity surface added in 1.12.0

Patient/rowan-mercier-no-health-card — claims conformance to Patient Profile

{
  "resourceType": "Patient",
  "id": "rowan-mercier-no-health-card",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-patient"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns='http://www.w3.org/1999/xhtml'><p>Rowan Mercier, a newly-arrived patient with NO provincial health card, seen at Cedarbrook Family Health.</p><p>This example exercises the must-support identity surface added in IG 1.12.0:</p><ul><li><strong>reason for no HCN</strong> -- Ontario's CA-eReC extension. Note it rides on the <em>MRN</em> identifier, not on a jurisdictional one: the extension's context is Patient.identifier, and in exactly the case it describes there is no jurisdictional identifier to attach it to. Ontario's vocabulary has only the single code #no-HC, so the operational specifics (IFHP coverage, application submitted) ride in .text. The binding is extensible, so a clinic MAY add a coded local reason beside the Ontario code -- but it must DECLARE that CodeSystem in the IG first; writing an undeclared canonical is the un-modeled-system defect this IG tracks.</li><li><strong>genderIdentity</strong> -- the HL7 individual-genderIdentity extension is COMPLEX: the concept lives in a `value` sub-extension and the extension root's value[x] is 0..0. This is the shape to copy.</li><li><strong>pronouns</strong> -- same complex shape, from the LOINC answer list.</li><li><strong>address.state / address.country</strong> -- the bare two-letter subdivision code and ISO 3166-1 alpha-2, both now required bindings.</li></ul></div>"
  },
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MR",
            "display": "Medical record number"
          }
        ]
      },
      "system": "../NamingSystem/patient-mrn",
      "value": "CDBK-004182",
      "use": "official",
      "extension": [
        {
          "url": "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-reason-for-no-HCN-EXT",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://ontariohealth.ca/fhir/CodeSystem/no-health-card-number-reason",
                "code": "no-HC",
                "display": "does not have a health card"
              }
            ],
            "text": "No Ontario health card: recently arrived, covered under the Interim Federal Health Program, provincial application submitted 2025-03-28."
          }
        }
      ]
    },
    {
      "use": "secondary",
      "system": "../NamingSystem/cedarbrook-clinic-patient-raw-code",
      "value": "EMR-4182"
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "33791000087105",
                "display": "Non-binary gender identity"
              }
            ],
            "text": "Non-binary"
          }
        }
      ]
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-pronouns",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://loinc.org",
                "code": "LA29520-6",
                "display": "they/them/their/theirs/themselves"
              }
            ],
            "text": "they/them"
          }
        }
      ]
    }
  ],
  "name": [
    {
      "use": "official",
      "family": "Mercier",
      "given": [
        "Rowan"
      ],
      "prefix": [
        "Mx."
      ]
    }
  ],
  "gender": "other",
  "birthDate": "1996-11-02",
  "telecom": [
    {
      "system": "phone",
      "value": "+1-416-555-0184",
      "use": "mobile"
    }
  ],
  "address": [
    {
      "use": "home",
      "line": [
        "48 Wellesley Street East",
        "Apt 12"
      ],
      "city": "Toronto",
      "state": "ON",
      "postalCode": "M4Y 1H4",
      "country": "CA"
    }
  ],
  "active": true,
  "managingOrganization": {
    "identifier": {
      "system": "../NamingSystem/organization-identifier",
      "value": "cedarbrook-clinic"
    },
    "display": "Cedarbrook Family Health"
  }
}