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  1. FHIR Specification Feedback
  2. FHIR-35092

Patient.birthDate should have min cardinality of 0

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Medium Medium
    • International Patient Summary (FHIR)
    • current
    • Patient Care
    • Patient (IPS)
    • Artifacts Summary
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      The ISO 27269 data set requires date of birth. If this was not required in the FHIR IG, we would not be compliant to the ISO specification, which is a primary aim of the implementation guide (see main page).

      That said, to make sure implementers know compliant IPS documents may be exchanged without a date of birth using the data-absent-reason extension, we have updated the example in the "Design" section on "Missing Data" to explicitly show how an "unknown" date of birth could be transmitted in an IPS. The issue has been marked "not persuasive with modification" to account for that change. 

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      The ISO 27269 data set requires date of birth. If this was not required in the FHIR IG, we would not be compliant to the ISO specification, which is a primary aim of the implementation guide (see main page). That said, to make sure implementers know compliant IPS documents may be exchanged without a date of birth using the data-absent-reason extension, we have updated the example in the "Design" section on "Missing Data" to explicitly show how an "unknown" date of birth could be transmitted in an IPS. The issue has been marked "not persuasive with modification" to account for that change. 
    • John DAmore / Laura Heermann-Langford : 6-0-0
    • Clarification
    • Non-substantive

    Description

       Patient.birthDate has been fixed to have a minimum cardinality of 1. This is inappropriate, as the patient's date of birth might not be known. We should not prohibit the exchange of IPS documents for a patient just because the Patient resource does not have a date of birth recorded. 

       

      Even if we take the current guidance from FHIR core that "At least an estimated year should be provided as a guess if the real DOB is unknown", it is unreasonable to assume that a reasonable guess could be made at the time of compiling the IPS document. Furthermore, this guidance from FHIR core is also in question in FHIR-35090.

      I recommend setting the minimum cardinality to 0 to allow the exchange of IPS documents for Patients that have no birthDate.

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            Unassigned Unassigned
            slagesse Spencer LaGesse
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