Patient

The Patient resource covers data for the “who” information about the patient. Its attributes are focused on the demographic information necessary to support administrative, financial, and logistic procedures. Use the Patient resource to fetch basic demographics and administrative information about an individual patient.

A Patient record is generally created and maintained by each organization providing care for the patient; therefore, a patient receiving care at multiple organizations may have information present in multiple Patient Resources.

Note: Not all concepts are included within the base Patient resource; for example, race, ethnicity, organ donor status, and nationality are not included. However, this information may be found in standard extensions or in profiles defined for specific jurisdictions, such as US Meaningful Use Program.

Related Resources

The Patient resource is referenced by these resources:

A-C	D-M	M-V
Annotation	DetectedIssue	MedicationAdministration
Account	Device	MedicationDispense
AdverseEvent	DeviceRequest	MedicationRequest
AllergyIntolerance	DeviceUseStatement	MedicationStatement
Appointment	DiagnosticReport	MolecularSequence
AppointmentResponse	DocumentManifest	NutritionOrder
AuditEvent	DocumentReference	Observation
Basic	Encounter	Patient (itself)
BiologicallyDerivedProduct	EnrollmentRequest	Person
BodyStructure	EpisodeOfCare	Procedure
CarePlan	ExplanationOfBenefit	Provenance
CareTeam	FamilyMemberHistory	QuestionnaireResponse
ChargeItem	Flag	RelatedPerson
Claim	Goal	RequestGroup
ClaimResponse	Group	ResearchSubject
ClinicalImpression	GuidanceResponse	RiskAssessment
Communication	ImagingStudy	Schedule
CommunicationRequest	Immunization	ServiceRequest
Composition	ImmunizationEvaluation	Signature
Condition	ImmunizationRecommendation	Specimen
Consent	Invoice	SupplyDelivery
Contract	List	SupplyRequest
Coverage	MeasureReport	Task
CoverageEligibilityRequest	Media	VisionPrescription
CoverageEligibilityResponse

The Patient resource defines the following Slices :

• Patient.identifier is sliced based on the value of pattern: type
• Patient.deceased[x] is sliced based on the value of type: $this

IDs

A Patient record’s Resource ID can never change. Therefore, the identifiers with which humans are concerned (often the MRN - Medical Record Number, or UR - Unit Record) should not be used for the resource’s ID, since MRN’s may change (for example, if the patient has duplicate records). Instead, these identifiers should be represented in the Patient.identifier list where they can be managed.

Linking Patient Records

Use the link element to assert that patient resources refer to the same patient, including the following scenarios where multiple patient records exist:

Duplicate Patient records

By using a link replaced-by, the record containing a link is marked as a duplicate and the link points forward to a record that should be used instead. Note that the record pointed to may in its turn have been identified as created in error and forward to yet another Patient resource. Records that replace another record may use a link type of replaces pointing to the old record.

Patient Records in a Patient Index

The link type refer is used to denote a patient record that maintains a summary of patient data and a list of one or more servers that are known to hold a more comprehensive and/or authoritative record of the same patient. This record acts as a Patient Index.

Distributed Patient record

In a distributed record, multiple systems keep separate patient records concerning the same patient. These records are not considered duplicates, but rather contain a distributed, potentially overlapping view of the patient’s data. In these records, links of type see also can be used to point to other patient records; these links need not be bilateral.

Person Resource vs. Patient Resource

On the surface the Person resource appears to be similar to the Patient resource; however, the Person resource is used to link instances of resources believed to be the same individual together. For example, you could use the Person entry to cross check changes to information made to one part of a record with values in another system.

Patient.contact vs. RelatedPerson

The contact element always travels with the Patient resource and cannot be used as the target of a reference. When related people need to be referenced by other resources, the USCoreRelatedPerson (8.2) resource must be used instead of the Patient Resource.

The relationship between a mother and a child

During a maternity encounter, the Patient and Encounter resources for the mother are used. After the child is born, new Patient, Encounter and RelatedPerson (for the mother) records are created. The child’s encounter should reference the mother’s encounter using the partOf property.

Using an MPI

The Master Patient Index (MPI) search targets and locates a specific single patient to record information about, therefore, reducing errors through selecting the wrong patient.

This is distinct from a regular search, which is used for finding lists of patients that share a property in common, such as living in a specific location, or fitting within an age range.

CARIN for Blue Button^®

The C4BB Patient structure is derived from USCorePatientProfile (3.12.1) and is used to convey information about the patient who received the services described on the claim. The USCorePatientProfile sets minimum expectations for the Patient resource.

Anticipated Queries

Use Postman to test Opala's Patient Access API by querying the API and returning the results. The Opala Collection is a group of API requests that are already saved in the Postman app and arranged in folders. You can access Opala's Patient Access Sandbox and, if you have the correct credentials, the production environment as well. For more information see Setting Up Postman in this documentation set.

The Patient resource encompasses demographics and other administrative information about an individual receiving care or other health-related services.

For More Information

• FHIR R4 Patient (8.1) resource
• Patient Gender and Sex (8.1.7)
• Mother and newborn relationships (8.1.8)
• Merging Patient records (8.1.9)
• Match a patient using an MPI (8.1.10)
• Detailed Descriptions (8.1.14) for the elements in the Patient resource
• Terminology Bindings (8.1.2.1) for the Patient resource
• Constraints (8.1.2.2) for the Patient resource
• Search Parameters (8.1.12) for the Patient resource
• CARIN for Blue Button^® Patient (10.20.1) resource profile.
• CARIN for Blue Button^® Patient (10.20.5) detailed descriptions
• CARIN for Blue Button^® Terminology Bindings (10.20.1.1.1) for the Patient resource profile
• CARIN for Blue Button^® Constraints (10.20.1.1.2) for the Patient resource profile