Patient

The Patient resource represents an individual receiving healthcare services. It contains demographics and other administrative information essential for care coordination, billing, and identity management across healthcare systems.

Overview

Maturity (R4+): Normative

The Patient resource achieved normative status in FHIR R4, meaning its structure is stable and backward-compatible changes only.

Common uses

• Patient Demographics: Name, birthdate, gender, address, contact information
• Patient Identification: Medical record numbers, national IDs, insurance member IDs
• Care Team Coordination: Communication preferences, contact persons, primary care provider
• Administrative: Deceased status, multiple birth indicator, photo

Key elements

Identifier

Patient identifiers are crucial for matching and linking records across systems.

{
  "resourceType": "Patient",
  "identifier": [
    {
      "use": "official",
      "type": {
        "coding": [{
          "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
          "code": "MR",
          "display": "Medical Record Number"
        }]
      },
      "system": "http://hospital.example.org/patients",
      "value": "12345"
    }
  ]
}

Name

Supports multiple names with use qualifiers (official, nickname, maiden, etc.).

{
  "name": [
    {
      "use": "official",
      "family": "Smith",
      "given": ["John", "Robert"],
      "prefix": ["Mr."]
    }
  ]
}

Telecom and address

Addresses, phone numbers, and email with use qualifiers and periods.

{
  "telecom": [
    {
      "system": "phone",
      "value": "+1-555-123-4567",
      "use": "mobile"
    },
    {
      "system": "email",
      "value": "john.smith@example.com",
      "use": "home"
    }
  ],
  "address": [
    {
      "use": "home",
      "type": "physical",
      "line": ["123 Main Street", "Apt 4B"],
      "city": "Springfield",
      "state": "IL",
      "postalCode": "62701",
      "country": "US"
    }
  ]
}

Version notes

FHIR R5 Enhancements

New in R5:

• deceased[x] now supports deceasedString for approximate death information (e.g., “early 2020”)
• contact.period added for time-bounded contact relationships
• Enhanced search parameters for better patient matching

FHIR R4 (Current Normative)

R4 Features:

• Stable, normative resource structure
• Full support for US Core profiles
• Production-ready for all healthcare systems

STU3 (Legacy)

Differences from R4:

• Simpler animal element (deprecated in R5, use extension instead)
• Different cardinality on some elements
• Consider migrating to R4 for better interoperability

Search

Common search parameters for Patient:

Parameter	Type	Description	Example
identifier	token	Patient identifier	GET /Patient?identifier=12345
name	string	Patient name	GET /Patient?name=Smith
family	string	Family name	GET /Patient?family=Smith
given	string	Given name	GET /Patient?given=John
birthdate	date	Birth date	GET /Patient?birthdate=1980-01-15
gender	token	Gender	GET /Patient?gender=male
phone	token	Phone number	GET /Patient?phone=555-123-4567
email	token	Email address	GET /Patient?email=john@example.com

Implementation considerations

Patient Matching

Patient matching is critical for avoiding duplicate records:

1. Use multiple identifiers when available
2. Implement fuzzy matching on names (account for typos)
3. Consider probabilistic matching algorithms
4. Use standardized address formats

Privacy and Security

• Patient resources contain PHI/PII - secure appropriately
• Implement proper consent management
• Use SMART on FHIR scopes: patient/Patient.read
• Consider patient-mediated exchange (patient can control access)

Profiles

US Core Patient Profile

For US implementations, use the US Core Patient Profile:

• Requires: identifier, name, gender, birthDate
• Must support: race, ethnicity, address, telecom
• Recommended: communication (preferred language)

Related resources

• Person: Administrative person (may link multiple Patient resources)
• RelatedPerson: Family members, caregivers, emergency contacts
• Practitioner: Healthcare providers
• PractitionerRole: Provider in specific role at organization

See also

• FHIR
• FHIR References and Identifiers