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Add hl7.fhir.uv.extensions.r4 (5.3.0) to implementationguides to resolve unresolved extension profiles #2

Description

@niccoreyes

Description

The FHIR server currently validates PH Core Patient resources and returns errors like:

SLICING_CANNOT_BE_EVALUATED: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved
SLICING_CANNOT_BE_EVALUATED: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved

These are standard R4 extension profiles (individual-genderIdentity, individual-recordedSexOrGender, patient-religion, patient-nationality, etc.) that are defined in the hl7.fhir.uv.extensions.r4 package.

Root Cause

The eRef/config/application.yaml under hapi.fhir.implementationguides is missing the hl7_extensions_r4 entry. The ph_eref entry explicitly excludes hl7.fhir.uv.extensions and hl7.fhir.uv.extensions.r4, and ph_core has fetchDependencies: false, so none of these extension definitions are loaded into the server.

Fix

Add the following block under hapi.fhir.implementationguides in eRef/config/application.yaml:

      hl7_extensions_r4:
        name: hl7.fhir.uv.extensions.r4
        version: 5.3.0
        reloadExisting: false
        installMode: STORE_AND_INSTALL
        fetchDependencies: true
        installResourceTypes:
          - StructureDefinition
          - SearchParameter
        dependencyExcludes:
          - "hl7.terminology.r5"
          - "hl7.terminology.r4"

Reference working config: https://github.com/niccoreyes/aiscream-jpa/blob/main/application.yaml

Validation

After applying the fix, a PH Core Patient resource like the one below should validate without the SLICING_CANNOT_BE_EVALUATED errors for genderIdentity and recordedSexOrGender.

Test Resource (Patient - patient-acs-example)

{
  "resourceType" : "Patient",
  "id" : "patient-acs-example",
  "meta" : {
    "profile" : ["https://fhir.doh.gov.ph/phcore/StructureDefinition/ph-core-patient"]
  },
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-acs-example</b></p><a name=\"patient-acs-example\"> </a><a name=\"hcpatient-acs-example\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ph-core-patient.html\">PH Core Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Juan Carlos Dela Cruz (official) Male, DoB: 1981-03-15 ( http://philhealth.gov.ph/fhir/Identifier/philhealth-id#PhilHealthID#63-584789845-5)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li><a href=\"tel:+63-917-123-4567\">+63-917-123-4567</a></li><li>123 Mabini Street Barangay Malinis City of Las Piñas 1740 PH (home)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>General Practitioner: <a href=\"Practitioner-practitioner-ed-example.html\">Practitioner Maria Clara Santos (official)</a></li><li>Managing Organization: <a href=\"Organization-organization-pgh-example.html\">Organization Philippine General Hospital</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"race of a patient.\"><a href=\"StructureDefinition-race.html\">Race</a></td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-Race 2036-2}\">Filipino</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The nationality of the patient.\">Patient Nationality:</td><td colspan=\"3\"><ul><li>code: <span title=\"Codes:{urn:iso:std:iso:3166 PH}\">Philippines</span></li><li>period: 1981-03-15 --&gt; (ongoing)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Highest educational attainment of the patient.\"><a href=\"StructureDefinition-educational-attainment.html\">Educational Attainment</a></td><td colspan=\"3\"><span title=\"Codes:{https://psa.gov.ph/classification/psced/level C201301}\">Elementary Graduate</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient's occupation.\">Occupation:</td><td colspan=\"3\"><ul><li>occupationClassification: <span title=\"Codes:{https://psa.gov.ph/classification/psoc/unit 911102}\">Street Food Vendor</span></li><li>occupationLength: 2015-01-01 --&gt; (ongoing)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"If the patient is a member of an indigenous group.\"><a href=\"StructureDefinition-indigenous-people.html\">Indigenous People</a></td><td colspan=\"3\">false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The patient's professed religious affiliations.\"><a href=\"http://hl7.org/fhir/extensions/5.3.0/StructureDefinition-patient-religion.html\">Patient Religion</a></td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ReligiousAffiliation 1041}\">Roman Catholic Church</span></td></tr></table></div>"
  },
  "extension" : [{
    "extension" : [{
      "url" : "code",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "urn:iso:std:iso:3166",
          "code" : "PH",
          "display" : "Philippines"
        }]
      }
    },
    {
      "url" : "period",
      "valuePeriod" : {
        "start" : "1981-03-15"
      }
    }],
    "url" : "http://hl7.org/fhir/StructureDefinition/patient-nationality"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/patient-religion",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ReligiousAffiliation",
        "code" : "1041",
        "display" : "Roman Catholic Church"
      }]
    }
  },
  {
    "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/indigenous-people",
    "valueBoolean" : false
  },
  {
    "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/race",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-Race",
        "code" : "2036-2",
        "display" : "Filipino"
      }]
    }
  },
  {
    "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/educational-attainment",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://psa.gov.ph/classification/psced/level",
        "code" : "C201301",
        "display" : "Elementary Graduate"
      }]
    }
  },
  {
    "extension" : [{
      "url" : "occupationClassification",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "https://psa.gov.ph/classification/psoc/unit",
          "code" : "911102",
          "display" : "Street Food Vendor"
        }]
      }
    },
    {
      "url" : "occupationLength",
      "valuePeriod" : {
        "start" : "2015-01-01"
      }
    }],
    "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/occupation"
  }],
  "identifier" : [{
    "system" : "http://philhealth.gov.ph/fhir/Identifier/philhealth-id",
    "value" : "63-584789845-5"
  }],
  "active" : true,
  "name" : [{
    "use" : "official",
    "family" : "Dela Cruz",
    "given" : ["Juan",
    "Carlos"]
  }],
  "telecom" : [{
    "system" : "phone",
    "value" : "+63-917-123-4567",
    "use" : "mobile"
  }],
  "gender" : "male",
  "birthDate" : "1981-03-15",
  "address" : [{
    "extension" : [{
      "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/city-municipality",
      "valueCoding" : {
        "system" : "https://psa.gov.ph/classification/psgc",
        "code" : "1380200000",
        "display" : "City of Las Piñas"
      }
    },
    {
      "url" : "https://fhir.doh.gov.ph/phcore/StructureDefinition/region",
      "valueCoding" : {
        "system" : "https://psa.gov.ph/classification/psgc",
        "code" : "1300000000",
        "display" : "National Capital Region"
      }
    }],
    "use" : "home",
    "type" : "both",
    "line" : ["123 Mabini Street",
    "Barangay Malinis"],
    "city" : "City of Las Piñas",
    "district" : "NCR",
    "postalCode" : "1740",
    "country" : "PH"
  }],
  "generalPractitioner" : [{
    "reference" : "Practitioner/practitioner-ed-example"
  }],
  "managingOrganization" : {
    "reference" : "Organization/organization-pgh-example"
  }
}

Current Validation Errors (OperationOutcome)

{
    "resourceType": "OperationOutcome",
    "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Operation Outcome</h1><table border=\"0\"><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[0], Line[12] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[1], Line[31] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[2], Line[41] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[3], Line[45] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[4], Line[55] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[5], Line[65] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[0], Line[12] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[1], Line[31] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[2], Line[41] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[3], Line[45] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[4], Line[55] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[5], Line[65] Col[4]]</td><td>Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.language, Line[7] Col[20]]</td><td>A definition for CodeSystem 'urn:ietf:bcp:47' could not be found, so the code cannot be validated</td></tr><tr><td style=\"font-weight: bold;\">INFORMATION</td><td>[Patient.extension[0].extension[0].value.ofType(CodeableConcept), Line[15] Col[8]]</td><td>Reference to draft CodeSystem urn:iso:std:iso:3166|1.0.0</td></tr><tr><td style=\"font-weight: bold;\">ERROR</td><td>[Patient.extension[0].extension[0].value.ofType(CodeableConcept), Line[15] Col[8]]</td><td>Unknown code 'PH' in the CodeSystem 'urn:iso:std:iso:3166' version '1.0.0'</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.extension[4].value.ofType(CodeableConcept), Line[57] Col[6]]</td><td>A definition for CodeSystem 'https://psa.gov.ph/classification/psced/level' could not be found, so the code cannot be validated</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.extension[5].extension[0].value.ofType(CodeableConcept), Line[68] Col[8]]</td><td>A definition for CodeSystem 'https://psa.gov.ph/classification/psoc/unit' could not be found, so the code cannot be validated</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.extension[5].extension[0].value.ofType(CodeableConcept), Line[68] Col[8]]</td><td>Unable to validate code https://psa.gov.ph/classification/psoc/unit#911102 - Unknown code &quot;https://psa.gov.ph/classification/psoc/unit#911102&quot;. Code validation occurred using a ValueSet expansion that was pre-calculated at 2026-06-18T05:08:17.623+00:00</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.extension[5].extension[0].value.ofType(CodeableConcept), Line[68] Col[8]]</td><td>None of the codings provided are in the value set 'Occupation Classifications' (https://fhir.doh.gov.ph/phcore/ValueSet/occupational-classifications|0.2.0), and a coding should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable) (codes = https://psa.gov.ph/classification/psoc/unit#911102)</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.address[0].extension[0].value.ofType(Coding), Line[105] Col[8]]</td><td>Unable to validate code https://psa.gov.ph/classification/psgc#1380200000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.address[0].extension[0].value.ofType(Coding), Line[105] Col[8]]</td><td>The Coding provided (https://psa.gov.ph/classification/psgc#1380200000) was not found in the value set 'Cities' (https://fhir.doh.gov.ph/phcore/ValueSet/cities|0.2.0), and a code should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable). (error message = Unable to validate code https://psa.gov.ph/classification/psgc#1380200000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc)</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.address[0].extension[1].value.ofType(Coding), Line[113] Col[8]]</td><td>Unable to validate code https://psa.gov.ph/classification/psgc#1300000000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient.address[0].extension[1].value.ofType(Coding), Line[113] Col[8]]</td><td>The Coding provided (https://psa.gov.ph/classification/psgc#1300000000) was not found in the value set 'Regions' (https://fhir.doh.gov.ph/phcore/ValueSet/regions|0.2.0), and a code should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable). (error message = Unable to validate code https://psa.gov.ph/classification/psgc#1300000000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc)</td></tr><tr><td style=\"font-weight: bold;\">WARNING</td><td>[Patient, Line[10] Col[3316]]</td><td>Resource has a language, but the XHTML does not have an lang or an xml:lang tag (needs both - see https://www.w3.org/TR/i18n-html-tech-lang/#langvalues)</td></tr></table></div>"
    },
    "issue": [
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 12
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[0]",
                "Line[12] Col[4]"
            ],
            "expression": [
                "Patient.extension[0]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 31
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[1]",
                "Line[31] Col[4]"
            ],
            "expression": [
                "Patient.extension[1]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 41
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[2]",
                "Line[41] Col[4]"
            ],
            "expression": [
                "Patient.extension[2]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 45
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[3]",
                "Line[45] Col[4]"
            ],
            "expression": [
                "Patient.extension[3]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 55
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[4]",
                "Line[55] Col[4]"
            ],
            "expression": [
                "Patient.extension[4]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 65
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-genderIdentity]] on Patient.extension:genderIdentity could not be resolved (@char 1)",
            "location": [
                "Patient.extension[5]",
                "Line[65] Col[4]"
            ],
            "expression": [
                "Patient.extension[5]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 12
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[0]",
                "Line[12] Col[4]"
            ],
            "expression": [
                "Patient.extension[0]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 31
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[1]",
                "Line[31] Col[4]"
            ],
            "expression": [
                "Patient.extension[1]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 41
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[2]",
                "Line[41] Col[4]"
            ],
            "expression": [
                "Patient.extension[2]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 45
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[3]",
                "Line[45] Col[4]"
            ],
            "expression": [
                "Patient.extension[3]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 55
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[4]",
                "Line[55] Col[4]"
            ],
            "expression": [
                "Patient.extension[4]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 65
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 4
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "SLICING_CANNOT_BE_EVALUATED"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "SLICING_CANNOT_BE_EVALUATED"
                    }
                ]
            },
            "diagnostics": "Slicing cannot be evaluated: Problem with use of resolve() - profile [CanonicalType[http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender]] on Patient.extension:sex could not be resolved (@char 1)",
            "location": [
                "Patient.extension[5]",
                "Line[65] Col[4]"
            ],
            "expression": [
                "Patient.extension[5]"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 7
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 20
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "A definition for CodeSystem 'urn:ietf:bcp:47' could not be found, so the code cannot be validated",
            "location": [
                "Patient.language",
                "Line[7] Col[20]"
            ],
            "expression": [
                "Patient.language"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 15
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "information",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "Reference to draft CodeSystem urn:iso:std:iso:3166|1.0.0",
            "location": [
                "Patient.extension[0].extension[0].value.ofType(CodeableConcept)",
                "Line[15] Col[8]"
            ],
            "expression": [
                "Patient.extension[0].extension[0].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 15
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "error",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "Unknown code 'PH' in the CodeSystem 'urn:iso:std:iso:3166' version '1.0.0'",
            "location": [
                "Patient.extension[0].extension[0].value.ofType(CodeableConcept)",
                "Line[15] Col[8]"
            ],
            "expression": [
                "Patient.extension[0].extension[0].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 57
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 6
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "A definition for CodeSystem 'https://psa.gov.ph/classification/psced/level' could not be found, so the code cannot be validated",
            "location": [
                "Patient.extension[4].value.ofType(CodeableConcept)",
                "Line[57] Col[6]"
            ],
            "expression": [
                "Patient.extension[4].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 68
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "A definition for CodeSystem 'https://psa.gov.ph/classification/psoc/unit' could not be found, so the code cannot be validated",
            "location": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)",
                "Line[68] Col[8]"
            ],
            "expression": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 68
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "Unable to validate code https://psa.gov.ph/classification/psoc/unit#911102 - Unknown code \"https://psa.gov.ph/classification/psoc/unit#911102\". Code validation occurred using a ValueSet expansion that was pre-calculated at 2026-06-18T05:08:17.623+00:00",
            "location": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)",
                "Line[68] Col[8]"
            ],
            "expression": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 68
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_TX_NoValid_2_CC"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_TX_NoValid_2_CC"
                    }
                ]
            },
            "diagnostics": "None of the codings provided are in the value set 'Occupation Classifications' (https://fhir.doh.gov.ph/phcore/ValueSet/occupational-classifications|0.2.0), and a coding should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable) (codes = https://psa.gov.ph/classification/psoc/unit#911102)",
            "location": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)",
                "Line[68] Col[8]"
            ],
            "expression": [
                "Patient.extension[5].extension[0].value.ofType(CodeableConcept)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 105
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "Unable to validate code https://psa.gov.ph/classification/psgc#1380200000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc",
            "location": [
                "Patient.address[0].extension[0].value.ofType(Coding)",
                "Line[105] Col[8]"
            ],
            "expression": [
                "Patient.address[0].extension[0].value.ofType(Coding)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 105
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_TX_NoValid_13"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_TX_NoValid_13"
                    }
                ]
            },
            "diagnostics": "The Coding provided (https://psa.gov.ph/classification/psgc#1380200000) was not found in the value set 'Cities' (https://fhir.doh.gov.ph/phcore/ValueSet/cities|0.2.0), and a code should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable).  (error message = Unable to validate code https://psa.gov.ph/classification/psgc#1380200000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc)",
            "location": [
                "Patient.address[0].extension[0].value.ofType(Coding)",
                "Line[105] Col[8]"
            ],
            "expression": [
                "Patient.address[0].extension[0].value.ofType(Coding)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 113
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_PassThrough_TX_Message"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_PassThrough_TX_Message"
                    }
                ]
            },
            "diagnostics": "Unable to validate code https://psa.gov.ph/classification/psgc#1300000000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc",
            "location": [
                "Patient.address[0].extension[1].value.ofType(Coding)",
                "Line[113] Col[8]"
            ],
            "expression": [
                "Patient.address[0].extension[1].value.ofType(Coding)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 113
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 8
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Terminology_TX_NoValid_13"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Terminology_TX_NoValid_13"
                    }
                ]
            },
            "diagnostics": "The Coding provided (https://psa.gov.ph/classification/psgc#1300000000) was not found in the value set 'Regions' (https://fhir.doh.gov.ph/phcore/ValueSet/regions|0.2.0), and a code should come from this value set unless it has no suitable code (note that the validator cannot judge what is suitable).  (error message = Unable to validate code https://psa.gov.ph/classification/psgc#1300000000 - No codes in ValueSet belong to CodeSystem with URL https://psa.gov.ph/classification/psgc)",
            "location": [
                "Patient.address[0].extension[1].value.ofType(Coding)",
                "Line[113] Col[8]"
            ],
            "expression": [
                "Patient.address[0].extension[1].value.ofType(Coding)"
            ]
        },
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-line",
                    "valueInteger": 10
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-col",
                    "valueInteger": 3316
                },
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id",
                    "valueString": "Language_XHTML_Lang_Missing1"
                }
            ],
            "severity": "warning",
            "code": "processing",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/java-core-messageId",
                        "code": "Language_XHTML_Lang_Missing1"
                    }
                ]
            },
            "diagnostics": "Resource has a language, but the XHTML does not have an lang or an xml:lang tag (needs both - see https://www.w3.org/TR/i18n-html-tech-lang/#langvalues)",
            "location": [
                "Patient",
                "Line[10] Col[3316]"
            ],
            "expression": [
                "Patient"
            ]
        }
    ]
}

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