Genomics-RelatedPerson

Used for linking Patients with other patients, e.g. in the case of proband and consultand within duo and trio testing.

For instances where clinical/demographic information for the related person are required, a Patient resource for the related person SHOULD be included, with the Patient.link field referencing the RelatedPerson. Elements duplicated across both the Patient and RelatedPerson SHOULD in this case be captured within the Patient resource only. The RelatedPerson resource then references the proband through the RelatedPerson.patient field.

Further use cases surrounding the use of RelatedPerson are pending further Duo/Trio scenarios.

Profile url FHIR Module Normative Status
https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson UKCore trial-use



idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
contactPreferenceI0..1Extension(Complex)
copyCorrespondenceIndicatorI0..1Extension(boolean)
modifierExtension?! I0..*Extension
identifierΣ0..*Identifier
activeS Σ ?!0..1boolean
patientS Σ I1..1Reference(Patient)
relationshipS Σ0..*CodeableConceptBinding
nameS Σ0..*HumanName
id0..1string
extensionI0..*Extension
id0..1string
otherContactSystemI0..1Extension(CodeableConcept)
value0..1System.String
valueS Σ0..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderΣ0..1codeBinding
birthDateΣ0..1date
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1codeBinding
textΣ0..1string
lineS Σ0..*string
cityS Σ0..1string
districtΣ0..1string
stateΣ0..1string
postalCodeS Σ0..1string
countryΣ0..1string
periodΣ I0..1Period
photoI0..*Attachment
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean

Differential from RelatedPerson

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
contactPreferenceI0..1Extension(Complex)
copyCorrespondenceIndicatorI0..1Extension(boolean)
modifierExtension?! I0..*Extension
identifierΣ0..*Identifier
activeS Σ ?!0..1boolean
patientS Σ I1..1Reference(Patient)
relationshipS Σ0..*CodeableConceptBinding
nameS Σ0..*HumanName
id0..1string
extensionI0..*Extension
id0..1string
otherContactSystemI0..1Extension(CodeableConcept)
value0..1System.String
valueS Σ0..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderΣ0..1codeBinding
birthDateΣ0..1date
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1codeBinding
textΣ0..1string
lineS Σ0..*string
cityS Σ0..1string
districtΣ0..1string
stateΣ0..1string
postalCodeS Σ0..1string
countryΣ0..1string
periodΣ I0..1Period
photoI0..*Attachment
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean

RelatedPerson
DefinitionInformation about a person that is involved in the care for a patient, but who is not the target of healthcare, nor has a formal responsibility in the care process.
Cardinality0...*
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: role
RelatedPerson.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

RelatedPerson.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
RelatedPerson.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
RelatedPerson.text
DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
RelatedPerson.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
RelatedPerson.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.extension:contactPreference
DefinitionThe preferred method of contact, contact times and written communication format given by a Patient or Related Person.
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.extension:copyCorrespondenceIndicator
DefinitionExtension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence.
Cardinality0...1
TypeExtension(boolean)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.identifier
DefinitionIdentifier for a person within a particular scope.
Cardinality0...*
TypeIdentifier
SummaryTrue
Requirements

People are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the patient. Examples are national person identifier and local identifier.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: NK1-33
  • rim: .id
RelatedPerson.active
DefinitionWhether this related person record is in active use.
Cardinality0...1
Typeboolean
Must SupportTrue
ModifierTrue
SummaryTrue
Requirements

Need to be able to mark a related person record as not to be used, such as if it was created in error.

Comments

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.status
  • rim: .statusCode
RelatedPerson.patient
DefinitionThe patient this person is related to.
Cardinality1...1
TypeReference(Patient)
Must SupportTrue
SummaryTrue
Requirements

We need to know which patient this RelatedPerson is related to.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PID-3
  • rim: scoper[classCode=PSN|ANM and determinerCode='INSTANCE']/playedRole[classCode='PAT']/id
RelatedPerson.relationship
DefinitionThe nature of the relationship between a patient and the related person.
Cardinality0...*
TypeCodeableConcept
Binding

The nature of the relationship between a patient and the related person.

UKCorePersonRelationshipType (extensible)
Must SupportTrue
SummaryTrue
Requirements

We need to know the relationship with the patient since it influences the interpretation of the information attributed to this person.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: NK1-3
  • rim: code
RelatedPerson.name
DefinitionA name associated with the person.
Cardinality0...*
TypeHumanName
Must SupportTrue
SummaryTrue
Requirements

Related persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.

Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN
  • rim: EN (actually, PN)
  • servd: ProviderName
  • v2: NK1-2
  • rim: name
RelatedPerson.telecom
DefinitionA contact detail for the person, e.g. a telephone number or an email address.
Cardinality0...*
TypeContactPoint
Must SupportTrue
SummaryTrue
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cpt-2: A system is required if a value is provided.
    value.empty() or system.exists()
Mappings
  • rim: n/a
  • v2: XTN
  • rim: TEL
  • servd: ContactPoint
  • v2: NK1-5 / NK1-6 / NK1-40
  • rim: telecom
RelatedPerson.telecom.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
RelatedPerson.telecom.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.telecom.system
DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact.
Cardinality0...1
Typecode
Binding

Telecommunications form for contact point.

ContactPointSystem (required)
Must SupportTrue
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XTN.3
  • rim: ./scheme
  • servd: ./ContactPointType
RelatedPerson.telecom.system.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
RelatedPerson.telecom.system.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.telecom.system.extension:otherContactSystem
DefinitionOther contact system value which extends the system element in the ContactPoint datatype.
Cardinality0...1
TypeExtension(CodeableConcept)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.telecom.system.value
DefinitionPrimitive value for code
Cardinality0...1
TypeSystem.String
RelatedPerson.telecom.value
DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XTN.1 (or XTN.12)
  • rim: ./url
  • servd: ./Value
RelatedPerson.telecom.use
DefinitionIdentifies the purpose for the contact point.
Cardinality0...1
Typecode
Binding

Use of contact point.

ContactPointUse (required)
ModifierTrue
SummaryTrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XTN.2 - but often indicated by field
  • rim: unique(./use)
  • servd: ./ContactPointPurpose
RelatedPerson.telecom.rank
DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Cardinality0...1
TypepositiveInt
SummaryTrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: n/a
RelatedPerson.telecom.period
DefinitionTime period when the contact point was/is in use.
Cardinality0...1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: N/A
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
RelatedPerson.gender
DefinitionAdministrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Cardinality0...1
Typecode
Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)
SummaryTrue
Requirements

Needed for identification of the person, in combination with (at least) name and birth date.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NK1-15
  • rim: administrativeGender
RelatedPerson.birthDate
DefinitionThe date on which the related person was born.
Cardinality0...1
Typedate
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: player.birthTime
RelatedPerson.address
DefinitionAddress where the related person can be contacted or visited.
Cardinality0...*
TypeAddress
Must SupportTrue
SummaryTrue
Requirements

Need to keep track where the related person can be contacted per postal mail or visited.

Comments

Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD
  • rim: AD
  • servd: Address
  • v2: NK1-4
  • rim: addr
RelatedPerson.address.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
RelatedPerson.address.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.address.use
DefinitionThe purpose of this address.
Cardinality0...1
Typecode
Binding

The use of an address.

AddressUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

home


Mappings
  • rim: n/a
  • v2: XAD.7
  • rim: unique(./use)
  • servd: ./AddressPurpose
RelatedPerson.address.type
DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
Cardinality0...1
Typecode
Binding

The type of an address (physical / postal).

AddressType (required)
SummaryTrue
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

both


Mappings
  • rim: n/a
  • v2: XAD.18
  • rim: unique(./use)
  • vcard: address type parameter
RelatedPerson.address.text
DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
Cardinality0...1
Typestring
SummaryTrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

137 Nowhere Street, Erewhon 9132


Mappings
  • rim: n/a
  • v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
  • rim: ./formatted
  • vcard: address label parameter
RelatedPerson.address.line
DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Cardinality0...*
Typestring
Must SupportTrue
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

137 Nowhere Street


Mappings
  • rim: n/a
  • v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
  • rim: AD.part[parttype = AL]
  • vcard: street
  • servd: ./StreetAddress (newline delimitted)
RelatedPerson.address.city
DefinitionThe name of the city, town, suburb, village or other community or delivery center.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
AliasMunicpality
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

Erewhon


Mappings
  • rim: n/a
  • v2: XAD.3
  • rim: AD.part[parttype = CTY]
  • vcard: locality
  • servd: ./Jurisdiction
RelatedPerson.address.district
DefinitionThe name of the administrative area (county).
Cardinality0...1
Typestring
SummaryTrue
AliasCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

Madison


Mappings
  • rim: n/a
  • v2: XAD.9
  • rim: AD.part[parttype = CNT | CPA]
RelatedPerson.address.state
DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
Cardinality0...1
Typestring
SummaryTrue
AliasProvince, Territory
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD.4
  • rim: AD.part[parttype = STA]
  • vcard: region
  • servd: ./Region
RelatedPerson.address.postalCode
DefinitionA postal code designating a region defined by the postal service.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
AliasZip
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

9132


Mappings
  • rim: n/a
  • v2: XAD.5
  • rim: AD.part[parttype = ZIP]
  • vcard: code
  • servd: ./PostalIdentificationCode
RelatedPerson.address.country
DefinitionCountry - a nation as commonly understood or generally accepted.
Cardinality0...1
Typestring
SummaryTrue
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD.6
  • rim: AD.part[parttype = CNT]
  • vcard: country
  • servd: ./Country
RelatedPerson.address.period
DefinitionTime period when address was/is in use.
Cardinality0...1
TypePeriod
SummaryTrue
Requirements

Allows addresses to be placed in historical context.

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Examples
General

{
  "start": "2010-03-23",
  "end": "2010-07-01"
}


Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: XAD.12 / XAD.13 + XAD.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
RelatedPerson.photo
DefinitionImage of the person.
Cardinality0...*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of persons. Fits with newer social media usage too.

Comments

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • att-1: If the Attachment has data, it SHALL have a contentType
    data.empty() or contentType.exists()
Mappings
  • rim: n/a
  • v2: ED/RP
  • rim: ED
  • v2: OBX-5 - needs a profile
  • rim: player[classCode='PSN' and determinerCode='INSTANCE']/desc
RelatedPerson.period
DefinitionThe period of time during which this relationship is or was active. If there are no dates defined, then the interval is unknown.
Cardinality0...1
TypePeriod
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime
RelatedPerson.communication
DefinitionA language which may be used to communicate with about the patient's health.
Cardinality0...*
TypeBackboneElement
Requirements

If a related person does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple RelatedPerson.Communication associations. If the RelatedPerson does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: LanguageCommunication
RelatedPerson.communication.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
RelatedPerson.communication.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.communication.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RelatedPerson.communication.language
DefinitionThe ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Cardinality1...1
TypeCodeableConcept
Binding

A language which may be used to communicate with the related person about the patient's health.

AllLanguages (required)
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
RelatedPerson.communication.preferred
DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Cardinality0...1
Typeboolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Comments

This language is specifically identified for communicating healthcare information.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: preferenceInd


FHIRMDSHL7v2
RelatedPerson.relationshipPatient - Relationship to proband, Previous genomic report - Patient's relationship to requesting patientNK1-3

Constraint Profiles

Profiles indicating preferred element cardinality for use in Genomics, not to be used for validation

nameprofile
NHSDigital_RelatedPerson_Genomicshttps://fhir.nhs.uk/StructureDefinition/NHSDigital-RelatedPerson-Genomics

Additional Guidance

patient

SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.

"patient": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },

relationship

SHOULD use the UK Core bound ValueSet and SHOULD be present in all instances of RelatedPerson wherever possible.

"relationship":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "SIS",
                    "display": "sister"
                }
            ]
        }
    ]