Scope and Usage

The Finnish Core Patient profile is intended to encapsulate the most common and basic data model of patients in Finnish social and healthcare systems. The profile also defines how to present data defined in Finnish legislation. As such the profile should be usable in most Finnish contexts.

Identifying information

In the context of Finnish national social and healthcare, the defined identifying information for a person are

• first (given) name
• family name
• name history
• national person identifier
• temporary identifier
• time of birth
• gender
• time of death.

The unique identifier is the national person identifier.

Patient identifier

There are two versions of the national person identifier for people living in Finland.

The official Personal Identifier Code (PIC, also known as HETU) is granted by the Digital And Population Data Services Agency. The oid for the official PIC is 1.2.246.21.

When an official PIC is not known or cannot be used for other reasons, a system may generate a Temporary Identifier. There are several ways to create an oid for the temporary identifier. The most typical ones are described in ISO OID-yksilöintitunnuksen käytön kansalliset periaatteet sosiaali- ja terveysalalla document (in Finnish).

There are two generally used methods to create a temporary identifier OID.

1. 1.2.246.10.<organization>.22.<year>, where <organization> is the official identifier (y-tunnus) of the organization and <year> the year when the temporary identifier is generated.
2. 1.2.246.10.<organization>.10.<location>.22.<year> where both the organization and the year are the same as above, and the location is the more specific location or unit (toimipaikka) of the organization in which the temporary identifier is created.

The first method is recommended.

The identifiers are presented to human readers in the 11 character format, without any oid information.

When a PIC is used for a Patient instance, the value of the identifier.use field SHOULD be official and the value of the identifier.type SHOULD be NNFIN (from the identifierType code system of the HL7 Terminology).

When the identifier.type is NNFIN, the value of the identifier SHALL be a Finnish national PIC.

In addition to person identifiers for people living in Finland, systems may use test identifiers that have a special range in the PIC format (the eighth character is 9). For instance, 020516C903K.

Other identifiers

Other identifiers can also be used to identify the patient. In many cases the national patient identifier is not required. In these cases systems SHOULD assign another unique identifier for patients. Note that these identifiers MAY be different for different apps, for instance. They SHOULD still be the same when the same app asks for the patient information multiple times.

Additional Information

Name

Systems SHOULD populate the .name.text field and clients SHOULD use that version of the name, when available.

Clients SHOULD be prepared for cases where the name is not available. Systems may allow individuals to limit the amount of information that is being shared with FHIR apps. Some privacy aware systems do not share names or any demographic information by default.

Times

Both time of birth and time of death SHOULD be recorded with the time component, if known. If the time of day is not known, the date SHALL be recorded as a date only, without the time component.

The birth time, when known, SHALL be recorded using the standard extension.

Use of non-disclosure information

Finnish citizens that have requested name and address protection (Non-disclosure for personal safety) are labeled with the security label. The preferred way to do this is shown below.

 <Patient xmlns="http://hl7.org/fhir">
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
      <code value="R"/>
      <display value="Restricted"/>
    </security>
  </meta>
...  [snip] ...
</Patient>

Use of this label should be interpreted according to the law, rouhgly meaning that only personnel using systems in their work are allowed to see the name and address for the patient.

Presenting guardian information

In some cases, a guardian could be appointed to the patient if the patients is for ex. incapable of managing one’s matters due to an illness. In these situations, the guardian’s information SHOULD be presented with RelatedPerson resource with the relationship type GUARD.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from IPAPatient

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id		1..1	id	Logical id of this artifact
meta
Slices for security		0..*	Coding	Information about non-disclosure (turvakielto) SHALL be handled in meta.security. Slice: Unordered, Open by value:system
security:non-disclosure		0..1	Coding	Security Labels applied to this resource
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
Slices for identifier		1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:PIC		0..1	Identifier	An identifier for this patient
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: official
type		0..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
system		0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization		0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link
other		1..1	Reference(FI Base Patient | RelatedPerson)	The other patient or related person resource that the link refers to
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id	Σ	1..1	id	Logical id of this artifact
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣC	1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
identifier:PIC	SΣC	0..1	Identifier	An identifier for this patient
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
active	?!SΣC	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient
gender	SΣ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link	?!SΣC	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(FI Base 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Patient.identifier.use	required	IdentifierUse
Patient.identifier:PIC.use	required	Pattern: official
Patient.identifier:PIC.type	extensible	Pattern: NNFIN
Patient.gender	required	AdministrativeGender
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	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 | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ipa-pat-1	error	Patient.identifier, Patient.identifier:PIC	At least one of Patient.identifier.system or Patient.identifier.type or Patient.identifier.assigner SHALL be present : system.exists() or type.exists() or assigner.exists()
ipa-pat-2	error	Patient.name	Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
ipa-pat-3	best practice	Patient.name	To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. : text.exists()
ipa-pat-4	error	Patient.active	If Patient.link is present, then Patient.active SHALL be present : link.exists() implies active.exists()

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id	Σ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
Slices for security	Σ	0..*	Coding	Information about non-disclosure (turvakielto) SHALL be handled in meta.security. Slice: Unordered, Open by value:system Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
security:non-disclosure	Σ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣC	1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:PIC	SΣC	0..1	Identifier	An identifier for this patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		0..1	uri	Identity of the terminology system
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	?!SΣC	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
gender	SΣ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	Σ	0..*	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: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address	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		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		1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
preferred		0..1	boolean	Language preference indicator
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link	?!SΣC	0..*	BackboneElement	Link to another patient 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(FI Base 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Patient.meta.security	extensible	All Security Labels
Patient.meta.security:non-disclosure	extensible	All Security Labels
Patient.meta.tag	example	CommonTags
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.identifier.use	required	IdentifierUse
Patient.identifier.type	extensible	Identifier Type Codes
Patient.identifier:PIC.use	required	Pattern: official
Patient.identifier:PIC.type	extensible	Pattern: NNFIN
Patient.gender	required	AdministrativeGender
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	PatientContactRelationship
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ipa-pat-1	error	Patient.identifier, Patient.identifier:PIC	At least one of Patient.identifier.system or Patient.identifier.type or Patient.identifier.assigner SHALL be present : system.exists() or type.exists() or assigner.exists()
ipa-pat-2	error	Patient.name	Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
ipa-pat-3	best practice	Patient.name	To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. : text.exists()
ipa-pat-4	error	Patient.active	If Patient.link is present, then Patient.active SHALL be present : link.exists() implies active.exists()
pat-1	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()

Differential View

This structure is derived from IPAPatient

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id		1..1	id	Logical id of this artifact
meta
Slices for security		0..*	Coding	Information about non-disclosure (turvakielto) SHALL be handled in meta.security. Slice: Unordered, Open by value:system
security:non-disclosure		0..1	Coding	Security Labels applied to this resource
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
Slices for identifier		1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:PIC		0..1	Identifier	An identifier for this patient
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: official
type		0..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
system		0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization		0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link
other		1..1	Reference(FI Base Patient | RelatedPerson)	The other patient or related person resource that the link refers to
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id	Σ	1..1	id	Logical id of this artifact
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣC	1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
identifier:PIC	SΣC	0..1	Identifier	An identifier for this patient
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
active	?!SΣC	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient
gender	SΣ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link	?!SΣC	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(FI Base 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Patient.identifier.use	required	IdentifierUse
Patient.identifier:PIC.use	required	Pattern: official
Patient.identifier:PIC.type	extensible	Pattern: NNFIN
Patient.gender	required	AdministrativeGender
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	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 | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ipa-pat-1	error	Patient.identifier, Patient.identifier:PIC	At least one of Patient.identifier.system or Patient.identifier.type or Patient.identifier.assigner SHALL be present : system.exists() or type.exists() or assigner.exists()
ipa-pat-2	error	Patient.name	Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
ipa-pat-3	best practice	Patient.name	To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. : text.exists()
ipa-pat-4	error	Patient.active	If Patient.link is present, then Patient.active SHALL be present : link.exists() implies active.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	IPAPatient	Information about an individual or animal receiving health care services
id	Σ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
Slices for security	Σ	0..*	Coding	Information about non-disclosure (turvakielto) SHALL be handled in meta.security. Slice: Unordered, Open by value:system Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
security:non-disclosure	Σ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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
municipality		0..1	Coding	Municipality presents the home municipality of the patients. This information is relevant for ex. in billing and listing available healthcare services. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣC	1..*	Identifier	PIC (aka HETU). Slice: Unordered, Open by value:use
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:PIC	SΣC	0..1	Identifier	An identifier for this patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		0..1	uri	Identity of the terminology system
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NNFIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.246.21
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	?!SΣC	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
gender	SΣ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	Σ	0..*	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: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address	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		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		1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
preferred		0..1	boolean	Language preference indicator
generalPractitioner		0..*	Reference(FI Base Organization | FI Base Practitioner | FI Base PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(FI Base Organization)	Organization that is the custodian of the patient record
link	?!SΣC	0..*	BackboneElement	Link to another patient 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(FI Base 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Patient.meta.security	extensible	All Security Labels
Patient.meta.security:non-disclosure	extensible	All Security Labels
Patient.meta.tag	example	CommonTags
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.identifier.use	required	IdentifierUse
Patient.identifier.type	extensible	Identifier Type Codes
Patient.identifier:PIC.use	required	Pattern: official
Patient.identifier:PIC.type	extensible	Pattern: NNFIN
Patient.gender	required	AdministrativeGender
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	PatientContactRelationship
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ipa-pat-1	error	Patient.identifier, Patient.identifier:PIC	At least one of Patient.identifier.system or Patient.identifier.type or Patient.identifier.assigner SHALL be present : system.exists() or type.exists() or assigner.exists()
ipa-pat-2	error	Patient.name	Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
ipa-pat-3	best practice	Patient.name	To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. : text.exists()
ipa-pat-4	error	Patient.active	If Patient.link is present, then Patient.active SHALL be present : link.exists() implies active.exists()
pat-1	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()

This structure is derived from IPAPatient

Summary

Mandatory: 1 element (2 nested mandatory elements)

Structures

This structure refers to these other structures:

• FI Base Organization (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-organization)
• FI Base Practitioner (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-practitioner)
• FI Base PractitionerRole (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-practitioner-role)
• FI Base Patient (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-patient)

Extensions

This structure refers to these extensions:

• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/municipality-code
• http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired

Slices

This structure defines the following Slices:

• The element Patient.meta.security is sliced based on the value of value:system
• The element Patient.identifier is sliced based on the value of value:use