# US Core 6.1.0 - 3.1.1 comparison

## Summary Differences Between US Core version 6.1.0 - 3.1.1 Patient Profile

See [this section](https://hl7.org/fhir/versions.html) in FHIR regarding forward breaking changes, backward breaking changes, and substantial changes. Consider scoring each change for server, client, IG editors.

### - [US Core Patient Profile](https://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html)
1. *Additional USCDI requirements* conformance type added for US Core elements: [^1]

|Must Support flag|Additional USCDI requirements Extension|Must Support for Certifying Systems|Must Support for All Systems
|:---:|:---:|:---:|:---:|
X|X|X|X
||X|X|
1. The following US Core Extensions are no longer Must Support: [^2]
:::warning
- US Core Birth Sex Extension
:::
1. The following US Core Extensions and Patient resource elements have been added to US Core as *Additional USCDI requirements*: [^2]
:::warning
- US Core Gender Identity Extension
- US Core Tribal Affiliation Extension
- US Core Sex Extension
- Patient.name.use
- Patient.name.suffix
- Patient.name.period
- Patient.deceased[x]
:::
2. The following elements are no longer Must Support element but still *Additional USCDI requirements* [^3]
:::warning
- US Core Race Extension
- US Core ethnicity Extension
- Patient.telecom
- Patient.address.period
- Patient.communication
:::
1. Birth Sex Required Valueset[^3]
:::warning
- Changed value for display: 'Unknown' vs 'unknown'
:::
1. OMB Ethnicity Category Required Valueset[^3]
:::warning
- Changed value for display: 'Non Hispanic or Latino' vs 'Not Hispanic or Latino'
:::
:::danger
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor ASKU asked but unknown
Added to expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK unknown
Added to expansion
:::
1. Detailed Ethnicity Required Valueset[^3]
:::danger
- urn:oid:2.16.840.1.113883.6.238 2133-7 Ethnicity Removed from expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor ASKU asked but unknown
Added to expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor OTH other
Added to expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK unknown
Added to expansion
:::
1. OMB Race Categories Required Valueset[^3]
:::warning
- Changed value for display: 'Unknown' vs 'unknown'
- Changed value for display: 'Asked but no answer' vs 'asked but unknown'
:::
:::danger
- urn:oid:2.16.840.1.113883.6.238 2131-1 Other Race Added to expansion
:::
1. Detailed Race Required Valueset[^3]
:::warning
- Changed value for display: 'Israeili' vs 'Israeli'
:::
:::danger
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor ASKU asked but unknown
Added to expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor OTH other
Added to expansion
- http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK unknown
Added to expansion
:::
1. USPS Two Letter Alphabetic Codes[^3]
:::danger
- changed code system url from `https://www.usps.com` to `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
:::
:::warning
- Changed value for display: 'Virgin Islands of the U.S.' vs 'Virgin Islands'
- AE Armed Forces Europe, the Middle East, and Canada Added to expansion
- AP Armed Forces Pacific Added to expansion
- AA Armed Forces Americas (except Canada) Added to expansion
:::
Sources:

[^3]: https://hl7.org/fhir/us/core/comparison-v3.1.1/sd-us-core-patient-us-core-patient.html

[^2]: (https://hl7.org/fhir/us/core/changes-between-versions.html#cross-version-comparisons)

[^1]: https://hl7.org/fhir/us/core/must-support.html#additional-uscdi-requirements