First Nation Registry Group Extension¶
| Canonical | ../StructureDefinition/nexus-emr-first-nation-registry-group |
|---|---|
| Status | draft · 1.26.0 |
| Base | Extension (constraint) |
| Context | Patient (element) |
| Source | FSH · JSON |
The First Nation registry group (band) the patient's Indian Act registration is held under, as stated. Bound REQUIRED to the curated band list: a band the list does not carry cannot be recorded until the list is updated, and because that list is seed-managed reference data rather than an IG artifact, updating it ships as data and needs no release. Independent of the registration status and the community affiliation.
FSH
The authored source of truth: extensions/PatientFirstNationAffiliationExtensions.fsh (edit on GitHub). One FSH file may define several related artifacts.
// PatientFirstNationAffiliationExtensions.fsh
// The patient's First Nation affiliation: the registry group (band) their
// registration is held under, and the community they affiliate with. Two
// extensions over one value domain — the curated First Nation band list
// (../ValueSet/nexus-first-nation-band), a curated
// seed maintained from the Indigenous Services Canada band list, where the
// code is the federal band number and the display is the band name.
//
// A Canadian URI Registry namespace for the same federal registry, for
// IDENTIFIER use, is believed to exist at
// https://fhir.infoway-inforoute.ca/NamingSystem/ca-federal-firstnation-band-id
// -- UNVERIFIED as of 2026-08-26, and not relied on here. Note that an
// identifier namespace is not a coding system: even once confirmed, that URI
// would be the `Identifier.system` for a band membership rather than the
// `Coding.system` these two extensions bind.
// The value set is seed-managed reference data (like the curated problem and
// procedure lists), not an IG artifact, so membership updates ship as data.
// That is what makes a REQUIRED binding affordable on both extensions: a band
// the list does not carry is added as data, without an IG release, so the
// closed binding never becomes a release gate on recording a patient. It was
// `extensible` until FHIR-94, which is the opposite of what both descriptions
// promised -- extensible permits a code from any system, while the text said a
// band outside the list could not be recorded at all.
//
// AND THE TWO FIELDS DO NOT SHARE A DOMAIN, though they share this value set.
// A band is a REGISTRY GROUP; a community is a place and a people. One band may
// hold several communities and reserves, and a person can affiliate with a
// community whose band does not hold their registration. Binding both here is a
// deliberate approximation, taken because the band list is the only curated
// Indigenous reference data we hold -- not an assertion that the two are the
// same. If a community vocabulary is ever curated, `community` moves to it and
// `registryGroup` does not.
//
// Band names beginning with the glottal stop rendered as a literal "?" (e.g.
// ?Akisq'nuk First Nation) are the names as registered; they sort before "A"
// under plain ordinal comparison by design and must not be "cleaned up".
// ===========================================================================
// First Nation registry group extension (on Patient)
// ===========================================================================
Extension: FirstNationRegistryGroupExtension
Id: nexus-emr-first-nation-registry-group
Title: "First Nation Registry Group Extension"
Description: "The First Nation registry group (band) the patient's Indian Act registration is held under, as stated. Bound REQUIRED to the curated band list: a band the list does not carry cannot be recorded until the list is updated, and because that list is seed-managed reference data rather than an IG artifact, updating it ships as data and needs no release. Independent of the registration status and the community affiliation."
* ^url = "../StructureDefinition/nexus-emr-first-nation-registry-group"
* ^status = #draft
* ^date = "2026-08-19"
* ^publisher = "WELLSTAR Technologies Corp."
* ^contact.name = "Nexus EMR FHIR Implementation Guide"
* ^contact.telecom.system = #url
* ^contact.telecom.value = ".."
* ^jurisdiction = urn:iso:std:iso:3166#CA "Canada"
* ^context[0].type = #element
* ^context[0].expression = "Patient"
* . ^short = "Registry group (band) the registration is held under"
* extension 0..0
* url 1..1
* value[x] 1..1 MS
* value[x] only CodeableConcept
* valueCodeableConcept from ../ValueSet/nexus-first-nation-band (required)
* valueCodeableConcept ^short = "Band, coded by federal band number with the band name as display"
// ===========================================================================
// First Nation community extension (on Patient)
// ===========================================================================
Extension: FirstNationCommunityExtension
Id: nexus-emr-first-nation-community
Title: "First Nation Community Extension"
Description: "The First Nation community the patient affiliates with, as stated — drawn from the same curated band list as the registry group but independent of it and of the registration status: a community can be recorded whatever the other fields hold. NOTE THAT THE BAND LIST IS AN APPROXIMATION OF THIS FIELD'S DOMAIN: a band is a registry group, and a community is not the same thing — one band may have several communities and reserves, and a person can affiliate with a community whose band does not hold their registration. The band list is the only curated Indigenous reference data this specification holds, so a community is recorded as the band nearest to it. Read a value here as the community the patient named, resolved to a band, and not as a claim about registration."
* ^url = "../StructureDefinition/nexus-emr-first-nation-community"
* ^status = #draft
* ^date = "2026-08-19"
* ^publisher = "WELLSTAR Technologies Corp."
* ^contact.name = "Nexus EMR FHIR Implementation Guide"
* ^contact.telecom.system = #url
* ^contact.telecom.value = ".."
* ^jurisdiction = urn:iso:std:iso:3166#CA "Canada"
* ^context[0].type = #element
* ^context[0].expression = "Patient"
* . ^short = "First Nation community the patient affiliates with"
* extension 0..0
* url 1..1
* value[x] 1..1 MS
* value[x] only CodeableConcept
* valueCodeableConcept from ../ValueSet/nexus-first-nation-band (required)
* valueCodeableConcept ^short = "Community, coded by federal band number with the band name as display (the band list approximates this domain -- see the definition)"