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.

Invariants

Every rule in force on a conforming instance. This profile rows are stated here; inherited rows come from the base resource and are listed so that a constraint named on an element is findable. Invariant keys elsewhere on this page link into this table.

Key	Source	Severity	On	Rule
patient-address-country-alpha2	this profile	warning	Patient.address	Address.country SHOULD be an ISO 3166-1 alpha-2 code ('CA'), not alpha-3 ('CAN') and not a country name ('Canada'). Alpha-3 is an edge/submission form only and must not be stored. country.empty() or country.matches('^[A-Za-z]{2}$')
patient-indian-registration-number-format	this profile	warning	Patient	An Indian registration number identifier's value, when carried, SHOULD be 9 or 10 digits. identifier.where(system = 'https://fhir.infoway-inforoute.ca/NamingSystem/ca-indigenous-northern-affairs-number').all(value.empty() or value.matches('^[0-9]{9,10}$'))
patient-indigenous-identity-absence-exclusive	this profile	warning	Patient	If a not-answered value (Asked But Declined / Do not know/ Not applicable) is recorded, it SHOULD be the only instance of the extension. extension.where(url = 'http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-indigenousIdentity').value.ofType(CodeableConcept).coding.where(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' or system = 'http://terminology.hl7.org/CodeSystem/data-absent-reason').exists() implies extension.where(url = 'http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-indigenousIdentity').count() = 1
patient-indigenous-identity-instances-clean	this profile	warning	Patient	Each instance SHOULD carry exactly one coding, and no two instances SHOULD repeat the same system
patient-name-family-or-given	this profile	warning	Patient	Patient.name: at least one name SHALL carry a family name, a given name, or text -- or a data-absent-reason extension (CA Baseline ipa-pat-2). Ontario's stricter 'family required' is applied as an edge transform on submission, not in the core profile. name.where(family.exists() or given.exists() or text.exists()).exists() or name.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
patient-racialized-group-absence-exclusive	this profile	warning	Patient	If a not-answered value (Asked But Declined / Do not know / Another race category) is recorded, it SHOULD be the only instance of the extension. extension.where(url = 'http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-racializedGroup').value.ofType(CodeableConcept).coding.where(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' or system = 'http://terminology.hl7.org/CodeSystem/data-absent-reason').exists() implies extension.where(url = 'http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-racializedGroup').count() = 1
patient-racialized-group-instances-clean	this profile	warning	Patient	Each instance SHOULD carry exactly one coding, and no two instances SHOULD repeat the same system
dom-2	inherited	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3	inherited	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference
dom-4	inherited	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	inherited	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6	inherited	warning	Patient	A resource should have narrative for robust management text.div.exists()
ele-1	inherited	error	Patient.meta	All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1	inherited	error	Patient.meta.extension	Must have either extensions or value[x], not both extension.exists() != value.exists()
pat-1	inherited	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists()