Leitfaden Basis DE (R4)

Name

Im Datentyp HumanName sind Felder für die üblicherweise verwendeten Namensbestandteile wie Vorname, Nachname und Präfix vorgesehen. Die Auswahl der Elemente folgt der Regel, dass im FHIR-Kern-Standard nur die Dinge spezifiziert werden, die in 80% der Fälle tatsächlich gebraucht werden (Siehe FHIR and Architectural Principles).

Die Datenstruktur, die auf den Deutschen gesetzlichen Krankenversichertenkarten ausgelesen werden kann, sieht jedoch zusätzliche Felder vor (z.B. Namenszusatz, Vorsatzwort) bzw. schränkt die Nutzung von Feldern ein (z.B. akademischer Titel).

Daher wurde das deutsche Profil für HumanName mit Extensions versehen, die es erlauben, die Granularität der Daten von den Versichertenkarten in FHIR 1:1 abzubilden.

Alle Extensions sind im Abschnitt Extensions für Patient dokumentiert.

Häufig ist dies jedoch nicht erforderlich, da die Standard-Felder family, given, prefix den meisten Systemen ausreichend Information bieten. Die Implementierung der Extensions ist daher nicht zwingend erforderlich. Es ist jedoch stets zu beachten, dass alle Informationen, die in den Extensions abgebildet werden, stets auch in den Standard-Feldern enthalten sein müssen, so dass Systeme, die die Extensions ignorieren, zwar Granularität, nicht jedoch Information verlieren.

Basis-Profil für Datentyp HumanName

Name: HumannameDeBasis (Simplifier Projekt Link)

Canonical: http://fhir.de/StructureDefinition/humanname-de-basis

HumanName	I		HumanName	Element Id HumanName Short description Personenname Definition Personenname mit in Deutschland üblichen Erweiterungen Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. Data Type HumanName Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` hum-1:Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden `family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue()` hum-2:Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden `family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue()` hum-3:Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden `family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue()` hum-4:Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden `prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue())` Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName
use	Σ ?!	0..1	codeBinding	Element Id HumanName.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data Type code Binding The use of a human name. NameUse (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN.7, but often indicated by which field contains the name rim:unique(./use) servd:./NamePurpose BDT:1211 (in BDT als Freitext!)
text	Σ	0..1	string	There are no (further) constraints on this element Element Id HumanName.text Short description Text representation of the full name Definition Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:implied by XPN.11 rim:./formatted
family	Σ	0..1	string	Element Id HumanName.family Short description Familienname Alternate names surname Definition Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN.1/FN.1 rim:./part[partType = FAM] servd:./FamilyName BDT:3120 + 3100 + 3101 KVDT:3100 + 3120 + 3101
extension	I	0..*	Extension	Element Id HumanName.family.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
namenszusatz	I	0..1	Extension(string)	Element Id HumanName.family.extension:namenszusatz Short description Namenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK") Alternate names extensions, user content Definition Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst Comments Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile "Namenszusatz" und "Vorsatzwort" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt. Das Vorsatzwort kann durch die Core-Extension own-prefix (Canonical: http://hl7.org/fhir/StructureDefinition/humanname-own-prefix) abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden. Data Type Extension(string) Extension URL http://fhir.de/StructureDefinition/humanname-namenszusatz Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A KVDT:3100 BDT:3100
nachname	I	0..1	Extension(string)	Element Id HumanName.family.extension:nachname Short description Nachname ohne Vor- und Zusätze Alternate names extensions, user content Definition Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens. Comments If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.3 rim:ENXP where Qualifiers = (BR) KVDT:3101 BDT:3101
vorsatzwort	I	0..1	Extension(string)	Element Id HumanName.family.extension:vorsatzwort Short description Vorsatzwort Alternate names extensions, user content Definition Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK") Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component. Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.2 rim:ENXP where Qualifiers = (VV, R) BDT:3120 KVDT:3120
given	Σ	0..*	string	Element Id HumanName.given Short description Vorname Alternate names first name, middle name Definition Vorname der Person Comments If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN.2 + XPN.3 rim:./part[partType = GIV] servd:./GivenNames KVDT:3102 BDT:3102
prefix	Σ	0..*	string	Element Id HumanName.prefix Short description Namensteile vor dem Vornamen Definition Namensteile vor dem Vornamen, z.B. akademischer Titel. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN.5 rim:./part[partType = PFX] servd:./TitleCode KVDT:3104 BDT:3104
extension	I	0..*	Extension	Element Id HumanName.prefix.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
prefix-qualifier	I	0..*	Extension(code)	Element Id HumanName.prefix.extension:prefix-qualifier Short description LS \| AC \| NB \| PR \| HON \| BR \| AD \| SP \| MID \| CL \| IN \| VV Alternate names extensions, user content Definition Spezialisierung der Art des Präfixes, z.B. "AC" für Akademische Titel Comments Used to indicate additional information about the name part and how it should be used. Data Type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ENXP.qualifier
suffix	Σ	0..*	string	Element Id HumanName.suffix Short description Namensteile nach dem Nachnamen Definition Namensteile nach dem Nachnamen Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN/4 rim:./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id HumanName.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XPN.13 + XPN.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate

Die Constraints hum-1 bis hum-4 zu beachten:

key	severity	human	expression
hum-1	error	Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden	family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue()
hum-2	error	Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden	family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue()
hum-3	error	Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden	family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue()
hum-4	error	Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden	prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue())

Beispiel: einfacher Name ohne Extensions

    <name>
        <family value="Mustermann" />
        <given value="Max" />
    </name>

Beispiel: Geburtsname

    <name>
        <use value="maiden" />
        <family value="Testinghausen" />
    </name>

Beispiel: Name mit Vorsatzwort

    <name>
        <use value="official" />
        <text value="Ludwig van Beethoven" />
        <family value="van Beethoven">
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-prefix">
                <valueString value="van" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
                <valueString value="Beethoven" />
            </extension>
        </family>
        <given value="Ludwig" />
    </name>

Beispiel: Name mit Vorsatzwort, Namenszusatz und akademischem Titel

    <name>
        <use value="official" />
        <text value="Prof. Dr. med. Dr. rer. nat. Fritz Julius Karl Freiherr von und zu Rathenburg vor der Isar, MdB" />
        <family value="Freiherr von und zu Rathenburg vor der Isar">
            <extension url="http://fhir.de/StructureDefinition/humanname-namenszusatz">
                <valueString value="Freiherr" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-prefix">
                <valueString value="von und zu" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
                <valueString value="Rathenburg vor der Isar" />
            </extension>
        </family>
        <given value="Fritz" />
        <given value="Julius" />
        <given value="Karl" />
        <prefix value="Prof. Dr. med. Dr. rer. nat.">
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier">
                <valueCode value="AC" />
            </extension>
        </prefix>
        <suffix value="MdB" />
    </name>