HL7 PD1 Segment: Patient Additional Demographics

The PD1 segment carries patient-level demographics that supplement PID — facts that are true of the patient rather than of any single visit. It records the patient's primary facility and primary care provider, living arrangement and dependency, advance-directive and living-will status, protection and publicity flags, and immunization-registry status. Where PID identifies the patient, PD1 adds the standing demographic and care-coordination details that follow the patient across encounters.

Purpose

PD1 holds additional, relatively stable demographic information about the patient: who their primary facility and primary care provider are, their living arrangement and dependency, handicap and student status, living-will and advance-directive codes, organ-donor status, protection and publicity preferences, and immunization-registry status. Because these attributes describe the person and not the encounter, PD1 is sent alongside PID in registration and update messages so downstream systems keep the patient record current.

Used in

PD1 appears in patient-registration and demographic-update messages, most commonly ADT (registration, update, and merge events) where it follows PID to enrich the patient record. It is also carried in other patient-scoped messages that need the standing demographic context. See ADT.

Field-by-field reference

Source: the Vorro HL7 segment database (extracted from the official v2-to-FHIR IG). R = required (cardinality min ≥ 1). Repeat = field may repeat. Length is not carried by the FHIR source and is shown as —.

Seq	Name	Data Type	Length	Req	Repeat	Table #	Description
PD1-1	Living Dependency	cwe	—	O	Y	—	Day/night care or other dependency status.
PD1-2	Living Arrangement	cwe	—	O	—	—	How the patient lives (alone, family, institution).
PD1-3	Patient Primary Facility	xon	—	O	Y	—	The patient's primary care facility/organization.
PD1-4	Patient Primary Care Provider Name & ID No.	xcn	—	O	Y	—	The patient's primary care provider(s).
PD1-5	Student Indicator	cwe	—	O	—	—	Whether the patient is a full- or part-time student.
PD1-6	Handicap	cwe	—	O	—	—	Disability or handicap of the patient.
PD1-7	Living Will Code	cwe	—	O	—	—	Whether the patient has a living will.
PD1-8	Organ Donor Code	cwe	—	O	—	—	Whether the patient is an organ donor.
PD1-9	Separate Bill	id	—	O	—	—	Whether charges are billed separately.
PD1-10	Duplicate Patient	cx	—	O	Y	—	Identifier(s) of a known duplicate patient.
PD1-11	Publicity Code	cwe	—	O	—	—	Patient's preference for disclosure/publicity.
PD1-12	Protection Indicator	id	—	O	—	—	Whether the patient's record is protected.
PD1-13	Protection Indicator Effective Date	dt	—	O	—	—	When the protection indicator takes effect.
PD1-14	Place of Worship	xon	—	O	Y	—	The patient's place of worship/congregation.
PD1-15	Advance Directive Code	cwe	—	O	Y	—	Advance-directive instructions on file.
PD1-16	Immunization Registry Status	cwe	—	O	—	HL70441	Patient's status in the immunization registry.
PD1-17	Immunization Registry Status Effective Date	dt	—	O	—	—	When the registry status takes effect.
PD1-18	Publicity Code Effective Date	dt	—	O	—	—	When the publicity code takes effect.
PD1-19	Military Branch	cwe	—	O	—	HL70140	Branch of military service.
PD1-20	Military Rank/Grade	cwe	—	O	—	HL70141	Military rank or grade.
PD1-21	Military Status	cwe	—	O	—	HL70142	Active, retired, or other military status.
PD1-22	Advance Directive Last Verified Date	dt	—	O	—	—	When the advance directive was last verified.

Most-used fields

PD1-3 Patient Primary Facility and PD1-4 Patient Primary Care Provider are the most-consumed fields — they tie the patient to their home organization and PCP for referrals and care coordination.
PD1-7 Living Will Code and PD1-15 Advance Directive Code drive advance-care-planning workflows and feed clinical decision support.
PD1-12 Protection Indicator flags records that need restricted handling, so privacy logic branches on it.
PD1-11 Publicity Code governs whether the patient may appear in directories or disclosures.
PD1-16 Immunization Registry Status connects the patient to the immunization registry for reporting.

Version differences (2.3 to 2.8.2)

2.3/2.4: PD1 established with the core demographic fields (living dependency/arrangement, primary facility, PCP, student/handicap, living will, organ donor).
2.5: coded fields move from CE toward CWE; immunization-registry and publicity effective-date fields are present.
2.7+: PD1-19/20/21 Military Branch/Rank/Status and PD1-22 Advance Directive Last Verified Date round out the segment.
Receivers built for 2.3 ignore the trailing fields they do not recognize.

Common mistakes

Putting standing patient demographics in PV1 (visit) when they belong in PD1 (patient), so they get lost when the visit ends.
Reading only the first repetition of PD1-3/PD1-4 when a patient has multiple facilities or providers.
Ignoring PD1-12 Protection Indicator and exposing a protected record in a directory or disclosure.
Treating PD1-7 Living Will and PD1-15 Advance Directive as the same field — they are distinct codes with distinct workflows.

Examples

Minimal valid PD1 (primary facility only):

PD1|||MERCYGEN CLINIC^^MG01

Fully-populated PD1:

PD1|N|F|MERCYGEN CLINIC^^MG01|9988^WELBY^MARCUS^^^^MD|F|H1^Visually impaired|Y|Y|N||N|N|20260101|FIRST PARISH^^FP01|AD1^DNR||||||||20260101

Annotated breakdown of the fully-populated example (selected fields):

PD1                              ← segment ID
N                                ← PD1-1  Living Dependency
F                                ← PD1-2  Living Arrangement (family)
MERCYGEN CLINIC^^MG01            ← PD1-3  Patient Primary Facility
9988^WELBY^MARCUS^^^^MD          ← PD1-4  Patient Primary Care Provider
H1^Visually impaired             ← PD1-6  Handicap
Y                                ← PD1-7  Living Will Code
Y                                ← PD1-8  Organ Donor Code
N                                ← PD1-12 Protection Indicator
FIRST PARISH^^FP01               ← PD1-14 Place of Worship
AD1^DNR                          ← PD1-15 Advance Directive Code

In-context inside an ADT^A01 (admit), PD1 after PID:

MSH|^~&|REG|MERCYGEN|EHR|MERCYGEN|20260609120000||ADT^A01^ADT_A01|MSG001|P|2.5.1
EVN|A01|20260609120000
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PD1|||MERCYGEN CLINIC^^MG01|9988^WELBY^MARCUS^^^^MD|||Y|Y
PV1|1|I|3WEST^301^A||||1234^SMITH^JANE^A^^^MD|||MED||||ADM|||||V0001|||||||||||||||||||||||20260609120000

In-context inside an ADT^A08 (update, protection and advance-directive set):

MSH|^~&|REG|MERCYGEN|EHR|MERCYGEN|20260612080000||ADT^A08^ADT_A01|MSG045|P|2.5.1
EVN|A08|20260612080000
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PD1|||MERCYGEN CLINIC^^MG01|9988^WELBY^MARCUS^^^^MD|||Y|Y|||N|Y|20260101||AD1^DNR
PV1|1|I|3WEST^301^A||||1234^SMITH^JANE^A^^^MD|||MED|||||||||V0001

FHIR mapping

Primary target resource: Patient. PD1 contributes the patient's general practitioner (facility and provider) plus disability and congregation extensions. PD1-7 Living Will Code maps to a separate Observation (LivingWill profile). Official ConceptMaps: Patient, Observation-LivingWill.

Key Patient mappings:

PD1 field	FHIR target (Patient)
PD1-3 Patient Primary Facility	`Patient.generalPractitioner` (Reference(Organization))
PD1-4 Patient Primary Care Provider	`Patient.generalPractitioner` (Reference(Practitioner))
PD1-6 Handicap	`Patient.extension` (patient-disability, valueCodeableConcept)
PD1-14 Place of Worship	`Patient.extension` (patient-congregation, valueString)

Living-will mapping (separate resource):

PD1 field	FHIR target (Observation-LivingWill)
PD1-7 Living Will Code	`Observation.valueCodeableConcept` (status `final`, code LOINC `75320-2`)

Fields without a published mapping in the IG ConceptMaps (PD1-1, PD1-2, PD1-5, PD1-8 through PD1-13, PD1-15 through PD1-22) are demographic or administrative details not represented on Patient or the LivingWill Observation; preserve them on the source side or route to local extensions.

Engine considerations

PD1 carries no required fields, but interfaces in practice expect PD1-3 and PD1-4 for referral and care-coordination routing.
Preserve the repeating fields (PD1-3, PD1-4, PD1-10, PD1-14, PD1-15) as arrays — a patient can have several facilities, providers, or directives.
Honor PD1-12 Protection Indicator before exposing the record downstream; gate directory and disclosure logic on it.
Keep PD1 demographics on the patient record, not the encounter, so they persist after the visit closes.

How Vorro parses and produces PD1

Vorro maps PD1-3 and PD1-4 to Patient.generalPractitioner (Organization and Practitioner references), decomposes PD1-6 Handicap into the patient-disability extension and PD1-14 Place of Worship into the patient-congregation extension, and emits PD1-7 Living Will Code as a separate Observation (LivingWill, LOINC 75320-2) per the official ConceptMap. Repeating facility, provider, and directive fields are preserved as arrays, and the protection indicator is carried through so privacy rules can act on it.

PID — the patient PD1 supplements.
PV1 — the visit context that travels with PID and PD1.
ADT messages — where PD1 follows PID in registration and update events.

Sources

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