FHIRsmith: ConceptMap/ConceptMap-R3-Patient-element-map-to-R4.json

FHIR IG analytics

Package	hl7.fhir.uv.xver-r3.r4
Resource Type	ConceptMap
Id	ConceptMap-R3-Patient-element-map-to-R4.json
FHIR Version	R4
Source	http://hl7.org/fhir/uv/xver-r3.r4/0.1.0/ConceptMap-R3-Patient-element-map-to-R4.html
URL	http://hl7.org/fhir/uv/xver/ConceptMap/R3-Patient-element-map-to-R4
Version	0.1.0
Status	active
Date	2026-03-17T16:03:24.0838847-05:00
Name	R3PatientElementMapToR4
Title	Cross-version mapping for FHIR STU3 Patient to FHIR R4 Patient
Realm	uv
Authority	hl7
Description	This ConceptMap represents cross-version mappings for elements from a FHIR STU3 Patient to FHIR R4.

Resources that use this resource

No resources found

Resources that this resource uses

StructureDefinition
hl7.fhir.uv.xver-r3.r4b#0.1.0	extension-Patient.animal	STU3: This patient is known to be an animal (non-human) (new)

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ConceptMap R3-Patient-element-map-to-R4

Mapping from http://hl7.org/fhir/3.0 to http://hl7.org/fhir/4.0

Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/Patient|3.0.2 to Patientversion: 4.0.1)

Source Code

Relationship

Target Code

Comment

Patient.meta (meta)

is equivalent to

Patient.meta

Element `Patient.meta` is mapped to FHIR R4 element `Patient.meta` as `Equivalent`.

Patient.implicitRules (implicitRules)

is equivalent to

Patient.implicitRules

Element `Patient.implicitRules` is mapped to FHIR R4 element `Patient.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Patient.language (language)

is equivalent to

Patient.language

Element `Patient.language` is mapped to FHIR R4 element `Patient.language` as `Equivalent`. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Patient.text (text)

is equivalent to

Patient.text

Element `Patient.text` is mapped to FHIR R4 element `Patient.text` as `Equivalent`. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Patient.contained (contained)

is equivalent to

Patient.contained

Element `Patient.contained` is mapped to FHIR R4 element `Patient.contained` as `Equivalent`. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Patient.identifier (identifier)

is equivalent to

Patient.identifier

Element `Patient.identifier` is mapped to FHIR R4 element `Patient.identifier` as `Equivalent`.

Patient.active (active)

is equivalent to

Patient.active

Element `Patient.active` is mapped to FHIR R4 element `Patient.active` as `Equivalent`. Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

Patient.name (name)

is equivalent to

Patient.name

Element `Patient.name` is mapped to FHIR R4 element `Patient.name` as `Equivalent`. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Patient.telecom (telecom)

is equivalent to

Patient.telecom

Element `Patient.telecom` is mapped to FHIR R4 element `Patient.telecom` as `Equivalent`. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

Patient.gender (gender)

is equivalent to

Patient.gender

Element `Patient.gender` is mapped to FHIR R4 element `Patient.gender` as `Equivalent`. The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

Patient.birthDate (birthDate)

is equivalent to

Patient.birthDate

Element `Patient.birthDate` is mapped to FHIR R4 element `Patient.birthDate` as `Equivalent`. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems).

Patient.deceased[x] (deceased[x])

is equivalent to

Patient.deceased[x]

Element `Patient.deceased[x]` is mapped to FHIR R4 element `Patient.deceased[x]` as `Equivalent`. The target context `Patient.deceased[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Patient`. If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Patient.address (address)

is equivalent to

Patient.address

Element `Patient.address` is mapped to FHIR R4 element `Patient.address` as `Equivalent`. Patient may have multiple addresses with different uses or applicable periods.

Patient.maritalStatus (maritalStatus)

is equivalent to

Patient.maritalStatus

Element `Patient.maritalStatus` is mapped to FHIR R4 element `Patient.maritalStatus` as `Equivalent`.

Patient.multipleBirth[x] (multipleBirth[x])

is equivalent to

Patient.multipleBirth[x]

Element `Patient.multipleBirth[x]` is mapped to FHIR R4 element `Patient.multipleBirth[x]` as `Equivalent`. The target context `Patient.multipleBirth[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Patient`. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).

Patient.photo (photo)

is equivalent to

Patient.photo

Element `Patient.photo` is mapped to FHIR R4 element `Patient.photo` as `Equivalent`.

Patient.contact (contact)

maps to wider concept

Patient.contact

Element `Patient.contact` is mapped to FHIR R4 element `Patient.contact` as `Equivalent`. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

Patient.contact.relationship (relationship)

is equivalent to

Patient.contact.relationship

Element `Patient.contact.relationship` is mapped to FHIR R4 element `Patient.contact.relationship` as `Equivalent`.

Patient.contact.name (name)

is equivalent to

Patient.contact.name

Element `Patient.contact.name` is mapped to FHIR R4 element `Patient.contact.name` as `Equivalent`.

Patient.contact.telecom (telecom)

is equivalent to

Patient.contact.telecom

Element `Patient.contact.telecom` is mapped to FHIR R4 element `Patient.contact.telecom` as `Equivalent`. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Patient.contact.address (address)

is equivalent to

Patient.contact.address

Element `Patient.contact.address` is mapped to FHIR R4 element `Patient.contact.address` as `Equivalent`.

Patient.contact.gender (gender)

is equivalent to

Patient.contact.gender

Element `Patient.contact.gender` is mapped to FHIR R4 element `Patient.contact.gender` as `Equivalent`.

Patient.contact.organization (organization)

is equivalent to

Patient.contact.organization

Element `Patient.contact.organization` is mapped to FHIR R4 element `Patient.contact.organization` as `Equivalent`.

Patient.contact.period (period)

is equivalent to

Patient.contact.period

Element `Patient.contact.period` is mapped to FHIR R4 element `Patient.contact.period` as `Equivalent`.

Patient.communication (communication)

maps to wider concept

Patient.communication

Element `Patient.communication` is mapped to FHIR R4 element `Patient.communication` as `Equivalent`. If no language is specified, this *implies* that the default local language is spoken. If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Patient.communication.language (language)

is equivalent to

Patient.communication.language

Element `Patient.communication.language` is mapped to FHIR R4 element `Patient.communication.language` as `Equivalent`. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Patient.communication.preferred (preferred)

is equivalent to

Patient.communication.preferred

Element `Patient.communication.preferred` is mapped to FHIR R4 element `Patient.communication.preferred` as `Equivalent`. This language is specifically identified for communicating healthcare information.

Patient.generalPractitioner (generalPractitioner)

is equivalent to

Patient.generalPractitioner

Element `Patient.generalPractitioner` is mapped to FHIR R4 element `Patient.generalPractitioner` as `Equivalent`. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.

Patient.managingOrganization (managingOrganization)

is equivalent to

Patient.managingOrganization

Element `Patient.managingOrganization` is mapped to FHIR R4 element `Patient.managingOrganization` as `Equivalent`. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Patient.link (link)

maps to wider concept

Patient.link

Element `Patient.link` is mapped to FHIR R4 element `Patient.link` as `Equivalent`. There is no assumption that linked patient records have mutual links. This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

Patient.link.other (other)

is equivalent to

Patient.link.other

Element `Patient.link.other` is mapped to FHIR R4 element `Patient.link.other` as `Equivalent`. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Patient.link.type (type)

is equivalent to

Patient.link.type

Element `Patient.link.type` is mapped to FHIR R4 element `Patient.link.type` as `Equivalent`.

Group 2 Mapping from http://hl7.org/fhir/StructureDefinition/Patient|3.0.2 to STU3: This patient is known to be an animal (non-human) (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

Patient.animal (animal)

is equivalent to

Extension (STU3: This patient is known to be an animal (non-human) (new))

Element `Patient.animal` has a context of Patient based on following the parent source element upwards and mapping to `Patient`. Element `Patient.animal` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

Patient.animal.species (species)

is equivalent to

Extension.extension:species (STU3: E.g. Dog, Cow (new))

Element `Patient.animal.species` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension. Element `Patient.animal.species` has a context of Patient based on following the parent source element upwards and mapping to `Patient`. Element `Patient.animal.species` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

Patient.animal.breed (breed)

is equivalent to

Extension.extension:breed (STU3: E.g. Poodle, Angus (new))

Element `Patient.animal.breed` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension. Element `Patient.animal.breed` has a context of Patient based on following the parent source element upwards and mapping to `Patient`. Element `Patient.animal.breed` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

Patient.animal.genderStatus (genderStatus)

is equivalent to

Extension.extension:genderStatus (STU3: E.g. Neutered, Intact (new))

Element `Patient.animal.genderStatus` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension. Element `Patient.animal.genderStatus` has a context of Patient based on following the parent source element upwards and mapping to `Patient`. Element `Patient.animal.genderStatus` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

Source1

{
  "resourceType": "ConceptMap",
  "id": "R3-Patient-element-map-to-R4",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/xver/ConceptMap/R3-Patient-element-map-to-R4",
  "version": "0.1.0",
  "name": "R3PatientElementMapToR4",
  "title": "Cross-version mapping for FHIR STU3 Patient to FHIR R4 Patient",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T16:03:24.0838847-05:00",
  "contact": [
    {
      "name": "FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "description": "This ConceptMap represents cross-version mappings for elements from a FHIR STU3 Patient to FHIR R4.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "sourceCanonical": "http://hl7.org/fhir/3.0",
  "targetUri": "http://hl7.org/fhir/4.0",
  "group": [
    {
      "source": "http://hl7.org/fhir/StructureDefinition/Patient",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/StructureDefinition/Patient",
      "targetVersion": "4.0.1",
      "element": [
        {
          "code": "Patient.meta",
          "display": "meta",
          "target": [
            {
              "code": "Patient.meta",
              "display": "Patient.meta",
              "equivalence": "equivalent",
              "comment": "Element `Patient.meta` is mapped to FHIR R4 element `Patient.meta` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.implicitRules",
          "display": "implicitRules",
          "target": [
            {
              "code": "Patient.implicitRules",
              "display": "Patient.implicitRules",
              "equivalence": "equivalent",
              "comment": "Element `Patient.implicitRules` is mapped to FHIR R4 element `Patient.implicitRules` as `Equivalent`.\nAsserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation."
            }
          ]
        },
        {
          "code": "Patient.language",
          "display": "language",
          "target": [
            {
              "code": "Patient.language",
              "display": "Patient.language",
              "equivalence": "equivalent",
              "comment": "Element `Patient.language` is mapped to FHIR R4 element `Patient.language` as `Equivalent`.\nLanguage is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."
            }
          ]
        },
        {
          "code": "Patient.text",
          "display": "text",
          "target": [
            {
              "code": "Patient.text",
              "display": "Patient.text",
              "equivalence": "equivalent",
              "comment": "Element `Patient.text` is mapped to FHIR R4 element `Patient.text` as `Equivalent`.\nContained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later."
            }
          ]
        },
        {
          "code": "Patient.contained",
          "display": "contained",
          "target": [
            {
              "code": "Patient.contained",
              "display": "Patient.contained",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contained` is mapped to FHIR R4 element `Patient.contained` as `Equivalent`.\nThis should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."
            }
          ]
        },
        {
          "code": "Patient.identifier",
          "display": "identifier",
          "target": [
            {
              "code": "Patient.identifier",
              "display": "Patient.identifier",
              "equivalence": "equivalent",
              "comment": "Element `Patient.identifier` is mapped to FHIR R4 element `Patient.identifier` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.active",
          "display": "active",
          "target": [
            {
              "code": "Patient.active",
              "display": "Patient.active",
              "equivalence": "equivalent",
              "comment": "Element `Patient.active` is mapped to FHIR R4 element `Patient.active` as `Equivalent`.\nDefault is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient\n\nThis element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active."
            }
          ]
        },
        {
          "code": "Patient.name",
          "display": "name",
          "target": [
            {
              "code": "Patient.name",
              "display": "Patient.name",
              "equivalence": "equivalent",
              "comment": "Element `Patient.name` is mapped to FHIR R4 element `Patient.name` as `Equivalent`.\nA patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns."
            }
          ]
        },
        {
          "code": "Patient.telecom",
          "display": "telecom",
          "target": [
            {
              "code": "Patient.telecom",
              "display": "Patient.telecom",
              "equivalence": "equivalent",
              "comment": "Element `Patient.telecom` is mapped to FHIR R4 element `Patient.telecom` as `Equivalent`.\nA Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone)."
            }
          ]
        },
        {
          "code": "Patient.gender",
          "display": "gender",
          "target": [
            {
              "code": "Patient.gender",
              "display": "Patient.gender",
              "equivalence": "equivalent",
              "comment": "Element `Patient.gender` is mapped to FHIR R4 element `Patient.gender` as `Equivalent`.\nThe gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error."
            }
          ]
        },
        {
          "code": "Patient.birthDate",
          "display": "birthDate",
          "target": [
            {
              "code": "Patient.birthDate",
              "display": "Patient.birthDate",
              "equivalence": "equivalent",
              "comment": "Element `Patient.birthDate` is mapped to FHIR R4 element `Patient.birthDate` as `Equivalent`.\nAt least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems)."
            }
          ]
        },
        {
          "code": "Patient.deceased[x]",
          "display": "deceased[x]",
          "target": [
            {
              "code": "Patient.deceased[x]",
              "display": "Patient.deceased[x]",
              "equivalence": "equivalent",
              "comment": "Element `Patient.deceased[x]` is mapped to FHIR R4 element `Patient.deceased[x]` as `Equivalent`.\nThe target context `Patient.deceased[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Patient`.\nIf there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.\n\nThis element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different."
            }
          ]
        },
        {
          "code": "Patient.address",
          "display": "address",
          "target": [
            {
              "code": "Patient.address",
              "display": "Patient.address",
              "equivalence": "equivalent",
              "comment": "Element `Patient.address` is mapped to FHIR R4 element `Patient.address` as `Equivalent`.\nPatient may have multiple addresses with different uses or applicable periods."
            }
          ]
        },
        {
          "code": "Patient.maritalStatus",
          "display": "maritalStatus",
          "target": [
            {
              "code": "Patient.maritalStatus",
              "display": "Patient.maritalStatus",
              "equivalence": "equivalent",
              "comment": "Element `Patient.maritalStatus` is mapped to FHIR R4 element `Patient.maritalStatus` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.multipleBirth[x]",
          "display": "multipleBirth[x]",
          "target": [
            {
              "code": "Patient.multipleBirth[x]",
              "display": "Patient.multipleBirth[x]",
              "equivalence": "equivalent",
              "comment": "Element `Patient.multipleBirth[x]` is mapped to FHIR R4 element `Patient.multipleBirth[x]` as `Equivalent`.\nThe target context `Patient.multipleBirth[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Patient`.\nWhere the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated)."
            }
          ]
        },
        {
          "code": "Patient.photo",
          "display": "photo",
          "target": [
            {
              "code": "Patient.photo",
              "display": "Patient.photo",
              "equivalence": "equivalent",
              "comment": "Element `Patient.photo` is mapped to FHIR R4 element `Patient.photo` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact",
          "display": "contact",
          "target": [
            {
              "code": "Patient.contact",
              "display": "Patient.contact",
              "equivalence": "wider",
              "comment": "Element `Patient.contact` is mapped to FHIR R4 element `Patient.contact` as `Equivalent`.\nContact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact."
            }
          ]
        },
        {
          "code": "Patient.contact.relationship",
          "display": "relationship",
          "target": [
            {
              "code": "Patient.contact.relationship",
              "display": "Patient.contact.relationship",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.relationship` is mapped to FHIR R4 element `Patient.contact.relationship` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact.name",
          "display": "name",
          "target": [
            {
              "code": "Patient.contact.name",
              "display": "Patient.contact.name",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.name` is mapped to FHIR R4 element `Patient.contact.name` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact.telecom",
          "display": "telecom",
          "target": [
            {
              "code": "Patient.contact.telecom",
              "display": "Patient.contact.telecom",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.telecom` is mapped to FHIR R4 element `Patient.contact.telecom` as `Equivalent`.\nContact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification."
            }
          ]
        },
        {
          "code": "Patient.contact.address",
          "display": "address",
          "target": [
            {
              "code": "Patient.contact.address",
              "display": "Patient.contact.address",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.address` is mapped to FHIR R4 element `Patient.contact.address` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact.gender",
          "display": "gender",
          "target": [
            {
              "code": "Patient.contact.gender",
              "display": "Patient.contact.gender",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.gender` is mapped to FHIR R4 element `Patient.contact.gender` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact.organization",
          "display": "organization",
          "target": [
            {
              "code": "Patient.contact.organization",
              "display": "Patient.contact.organization",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.organization` is mapped to FHIR R4 element `Patient.contact.organization` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.contact.period",
          "display": "period",
          "target": [
            {
              "code": "Patient.contact.period",
              "display": "Patient.contact.period",
              "equivalence": "equivalent",
              "comment": "Element `Patient.contact.period` is mapped to FHIR R4 element `Patient.contact.period` as `Equivalent`."
            }
          ]
        },
        {
          "code": "Patient.communication",
          "display": "communication",
          "target": [
            {
              "code": "Patient.communication",
              "display": "Patient.communication",
              "equivalence": "wider",
              "comment": "Element `Patient.communication` is mapped to FHIR R4 element `Patient.communication` as `Equivalent`.\nIf no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required."
            }
          ]
        },
        {
          "code": "Patient.communication.language",
          "display": "language",
          "target": [
            {
              "code": "Patient.communication.language",
              "display": "Patient.communication.language",
              "equivalence": "equivalent",
              "comment": "Element `Patient.communication.language` is mapped to FHIR R4 element `Patient.communication.language` as `Equivalent`.\nThe structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type."
            }
          ]
        },
        {
          "code": "Patient.communication.preferred",
          "display": "preferred",
          "target": [
            {
              "code": "Patient.communication.preferred",
              "display": "Patient.communication.preferred",
              "equivalence": "equivalent",
              "comment": "Element `Patient.communication.preferred` is mapped to FHIR R4 element `Patient.communication.preferred` as `Equivalent`.\nThis language is specifically identified for communicating healthcare information."
            }
          ]
        },
        {
          "code": "Patient.generalPractitioner",
          "display": "generalPractitioner",
          "target": [
            {
              "code": "Patient.generalPractitioner",
              "display": "Patient.generalPractitioner",
              "equivalence": "equivalent",
              "comment": "Element `Patient.generalPractitioner` is mapped to FHIR R4 element `Patient.generalPractitioner` as `Equivalent`.\nThis may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources."
            }
          ]
        },
        {
          "code": "Patient.managingOrganization",
          "display": "managingOrganization",
          "target": [
            {
              "code": "Patient.managingOrganization",
              "display": "Patient.managingOrganization",
              "equivalence": "equivalent",
              "comment": "Element `Patient.managingOrganization` is mapped to FHIR R4 element `Patient.managingOrganization` as `Equivalent`.\nThere is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association)."
            }
          ]
        },
        {
          "code": "Patient.link",
          "display": "link",
          "target": [
            {
              "code": "Patient.link",
              "display": "Patient.link",
              "equivalence": "wider",
              "comment": "Element `Patient.link` is mapped to FHIR R4 element `Patient.link` as `Equivalent`.\nThere is no assumption that linked patient records have mutual links. \n\nThis element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'."
            }
          ]
        },
        {
          "code": "Patient.link.other",
          "display": "other",
          "target": [
            {
              "code": "Patient.link.other",
              "display": "Patient.link.other",
              "equivalence": "equivalent",
              "comment": "Element `Patient.link.other` is mapped to FHIR R4 element `Patient.link.other` as `Equivalent`.\nReferencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual."
            }
          ]
        },
        {
          "code": "Patient.link.type",
          "display": "type",
          "target": [
            {
              "code": "Patient.link.type",
              "display": "Patient.link.type",
              "equivalence": "equivalent",
              "comment": "Element `Patient.link.type` is mapped to FHIR R4 element `Patient.link.type` as `Equivalent`."
            }
          ]
        }
      ]
    },
    {
      "source": "http://hl7.org/fhir/StructureDefinition/Patient",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/3.0/StructureDefinition/extension-Patient.animal",
      "targetVersion": "0.1.0",
      "element": [
        {
          "code": "Patient.animal",
          "display": "animal",
          "target": [
            {
              "code": "Extension",
              "equivalence": "equivalent",
              "comment": "Element `Patient.animal` has a context of Patient based on following the parent source element upwards and mapping to `Patient`.\nElement `Patient.animal` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nThe animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal)."
            }
          ]
        },
        {
          "code": "Patient.animal.species",
          "display": "species",
          "target": [
            {
              "code": "Extension.extension:species",
              "equivalence": "equivalent",
              "comment": "Element `Patient.animal.species` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension.\nElement `Patient.animal.species` has a context of Patient based on following the parent source element upwards and mapping to `Patient`.\nElement `Patient.animal.species` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nIf the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.)."
            }
          ]
        },
        {
          "code": "Patient.animal.breed",
          "display": "breed",
          "target": [
            {
              "code": "Extension.extension:breed",
              "equivalence": "equivalent",
              "comment": "Element `Patient.animal.breed` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension.\nElement `Patient.animal.breed` has a context of Patient based on following the parent source element upwards and mapping to `Patient`.\nElement `Patient.animal.breed` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nBreed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type."
            }
          ]
        },
        {
          "code": "Patient.animal.genderStatus",
          "display": "genderStatus",
          "target": [
            {
              "code": "Extension.extension:genderStatus",
              "equivalence": "equivalent",
              "comment": "Element `Patient.animal.genderStatus` is part of an existing definition because parent element `Patient.animal` requires a cross-version extension.\nElement `Patient.animal.genderStatus` has a context of Patient based on following the parent source element upwards and mapping to `Patient`.\nElement `Patient.animal.genderStatus` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element)."
            }
          ]
        }
      ]
    }
  ]
}