US Core Patient required fields checklist
The elements you need to populate to satisfy the US Core Patient profile, with the must-support data elements and the US-specific extensions that trip people up.
US Core is the realm-specific set of FHIR profiles for the United States, aligned with regulatory requirements. The Patient profile constrains the base FHIR Patient with must-support elements and a few US-specific extensions.
This checklist reflects the well-known US Core Patient requirements. Always validate against the published US Core version your project targets, since must-support details evolve between releases.
Core data elements
Elements US Core Patient expects systems to support.
| Element | Requirement | Notes |
|---|---|---|
| identifier | Must support | At least one identifier with a system and a value. The MRN typically maps here. |
| identifier.system | Required within identifier | A URI namespace for the identifier. |
| identifier.value | Required within identifier | The actual identifier value. |
| name | Must support | At least one name. US Core expects a usable name representation. |
| name.family or name.given | At least one required | A name needs a family name or a given name (data-absent handling applies when truly unknown). |
| gender | Must support | administrative gender: male, female, other, or unknown. |
| birthDate | Must support | Date of birth. |
Common supported elements
Frequently required by downstream use; support is expected.
| Element | Requirement | Notes |
|---|---|---|
| telecom | Must support | Phone or email contact points (system and value). |
| address | Must support | Patient address. |
| communication.language | Must support | Preferred language, bound to a language value set. |
US-specific extensions
The extensions that distinguish US Core from base FHIR Patient.
| Extension | Requirement | Notes |
|---|---|---|
| US Core Race | Must support | OMB race categories plus optional detailed codes and a text. |
| US Core Ethnicity | Must support | OMB ethnicity (Hispanic or Latino / Not Hispanic or Latino) plus optional detail and text. |
| US Core Birth Sex | Must support | Sex assigned at birth, distinct from administrative gender. |
Notes
- Must support means a system has to be able to populate and process the element, not that every instance must contain it. Validate against your target US Core version for the exact rules.
- Race, ethnicity, and birth sex are carried as extensions on Patient, not as plain elements. Mapping from HL7v2 PID needs explicit extension handling.
- administrative gender (gender) and birth sex are different concepts and are populated separately.
Frequently asked questions
What fields are required for US Core Patient?
US Core Patient marks identifier, name, gender, and birthDate as must-support core elements, and requires the US-specific race, ethnicity, and birth sex extensions to be supported. Telecom, address, and communication language are also must-support.
What is the difference between must-support and required in US Core?
Required (cardinality 1..*) means the element must be present. Must-support means a conforming system must be able to populate and process the element when the data is available. US Core relies heavily on must-support.
Are race and ethnicity standard FHIR elements?
No. In US Core they are carried as extensions on the Patient resource (US Core Race and US Core Ethnicity), using OMB categories. Base FHIR Patient has no race or ethnicity element.
How do I check a Patient against US Core?
Validate the resource against the US Core Patient profile. The Interoperall FHIR validator reports required-element and structural issues against profiles including US Core in the browser.