RelatedPerson Profile

Canonical	../StructureDefinition/nexus-emr-core-relatedperson
Status	draft · 1.26.0
Base	RelatedPerson (constraint)
Source	FSH · JSON

Nexus EMR profile for RelatedPerson, capturing an alternative contact for a patient — a person the practice can reach on the patient's behalf, with a personal relationship, any number of contact purposes, contact details, an optional note, and an optional primary (call-first) flag. Backs the Patient Profile Relationships section.

Elements / Details

Every element this profile touches, with its full definition. Element names in the tables link here.

RelatedPerson

Short	Nexus EMR RelatedPerson Core
Definition	Represents an alternative contact linked to a patient. The personal relationship is drawn from the official RelatedPerson relationship-type value set — HL7 v3 PersonalRelationshipRoleType concepts plus the v2-0131 "O" (Other) member — with v3 RoleCode GUARD (guardian) covering the legal guardian the set has no concept for; zero or more contact purposes from the Nexus EMR contact-purpose system may accompany it in the same relationship array. At most one related person per patient carries the primary (call-first) flag.
Cardinality	0..*
Invariants	dom-2, dom-3, dom-4, dom-5, dom-6

RelatedPerson.id

Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
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.
Cardinality	0..1
Type	http://hl7.org/fhirpath/System.String

RelatedPerson.meta

Short	Metadata about the resource
Definition	The 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.
Cardinality	0..1
Type	Meta
Invariants	ele-1

RelatedPerson.meta.id

Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	http://hl7.org/fhirpath/System.String

RelatedPerson.meta.extension

Short	Additional content defined by implementations
Definition	May 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.
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.
Cardinality	0..*
Type	Extension
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.meta.versionId

Short	Version specific identifier
Definition	The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Comments	The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Cardinality	0..1
Type	id
Invariants	ele-1

RelatedPerson.meta.lastUpdated

Short	When the resource version last changed
Definition	When the resource last changed - e.g. when the version changed.
Comments	This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Cardinality	0..1
Type	instant
Invariants	ele-1

RelatedPerson.meta.source

Short	Identifies EMR instance & pipeline version the resource came from
Definition	A URI that identifies the EMR pipeline and version from which this resource originated.
Comments	In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Cardinality	0..1
Type	uri
Must Support	yes
Invariants	ele-1

RelatedPerson.meta.profile

Short	Profiles this resource claims to conform to
Definition	A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Comments	It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Cardinality	0..*
Type	canonical
Invariants	ele-1

RelatedPerson.meta.security

Short	Security Labels applied to this resource
Definition	Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Comments	The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Cardinality	0..*
Type	Coding
Binding	security-labels (extensible)
Invariants	ele-1

RelatedPerson.meta.tag

Short	Tags applied to this resource
Definition	Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Comments	The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Cardinality	0..*
Type	Coding
Binding	common-tags (example)
Invariants	ele-1

RelatedPerson.implicitRules

Short	A set of rules under which this content was created
Definition	A 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.
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.
Cardinality	0..1
Type	uri
Modifier	yes — This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Invariants	ele-1

RelatedPerson.language

Short	Language of the resource content
Definition	The base language in which the resource is written.
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).
Cardinality	0..1
Type	code
Binding	languages (preferred)
Invariants	ele-1

RelatedPerson.text

Short	Narrative
Definition	A human-readable narrative summary of the NexusEmrCoreRelatedPerson resource for human interpretation.
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.
Cardinality	0..1
Type	Narrative
Must Support	yes
Invariants	ele-1
Also called	narrative, html, xhtml, display

RelatedPerson.contained

Short	Contained, inline Resources
Definition	These 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.
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.
Cardinality	0..*
Type	Resource
Also called	inline resources, anonymous resources, contained resources

RelatedPerson.extension

Short	Additional content defined by implementations
Definition	May 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.
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.
Cardinality	0..*
Type	Extension
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.extension:primary

Short	Whether this is the primary (call-first) contact
Definition	May 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.
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.
Cardinality	0..1
Type	Extension(Contact Primary Extension)
Must Support	yes
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.extension:note

Short	Free-text note about the contact
Definition	May 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.
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.
Cardinality	0..1
Type	Extension(Contact Note Extension)
Must Support	yes
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.modifierExtension

Short	Extensions that cannot be ignored
Definition	May 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).
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.
Cardinality	0..*
Type	Extension
Modifier	yes — Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.identifier

Short	A human identifier for this person
Definition	Identifier for a person within a particular scope.
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.
Cardinality	0..*
Type	Identifier
Invariants	ele-1

RelatedPerson.active

Short	Whether this related person's record is in active use
Definition	Whether this related person record is in active use.
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.
Cardinality	0..1
Type	boolean
Modifier	yes — This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Invariants	ele-1

RelatedPerson.patient

Short	The patient this person is a contact for
Definition	The patient on whose behalf this person can be contacted.
Requirements	We need to know which patient this RelatedPerson is related to.
Cardinality	1..1
Type	Reference(Patient)
Must Support	yes
Invariants	ele-1

RelatedPerson.relationship

Short	Personal relationship to the patient, plus any contact purposes
Definition	The nature of the relationship between a patient and the related person.
Requirements	We need to know the relationship with the patient since it influences the interpretation of the information attributed to this person.
Comments	Carries the personal relationship (a member of the official relatedperson-relationshiptype value set — HL7 v3 PersonalRelationshipRoleType or v2-0131 'O' — with v3 RoleCode GUARD for legal guardian) and zero or more contact purposes (the local contact-purpose system, dual-coded with an official v2-0131 / v3 RoleCode / v3 RoleClass code where one exists). Readers discriminate the relationship by matching system AND code against the relationship value set. Where this code was mapped from a source system's own vocabulary, carry the raw coding alongside the mapped one, flagged userSelected = true. See Carrying the raw code.
Cardinality	0..*
Type	CodeableConcept
Must Support	yes
Binding	relatedperson-relationshiptype (preferred)
Invariants	ele-1

RelatedPerson.name

Short	The contact's name
Definition	A name associated with the person.
Requirements	Related persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.
Cardinality	0..*
Type	HumanName
Must Support	yes
Invariants	ele-1

RelatedPerson.telecom

Short	The contact's phone numbers and e-mail (a work number's extension rides on the contact-point-phone-extension)
Definition	A contact detail for the person, e.g. a telephone number or an email address.
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.
Cardinality	0..*
Type	ContactPoint
Must Support	yes
Invariants	ele-1

RelatedPerson.gender

Short	male | female | other | unknown
Definition	Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Requirements	Needed for identification of the person, in combination with (at least) name and birth date.
Cardinality	0..1
Type	code
Binding	administrative-gender (required)
Invariants	ele-1

RelatedPerson.birthDate

Short	The date on which the related person was born
Definition	The date on which the related person was born.
Cardinality	0..1
Type	date
Invariants	ele-1

RelatedPerson.address

Short	Address where the related person can be contacted or visited
Definition	Address where the related person can be contacted or visited.
Requirements	Need to keep track where the related person can be contacted per postal mail or visited.
Cardinality	0..*
Type	Address
Invariants	ele-1

RelatedPerson.photo

Short	Image of the person
Definition	Image of the person.
Requirements	Many EHR systems have the capability to capture an image of persons. Fits with newer social media usage too.
Cardinality	0..*
Type	Attachment
Invariants	ele-1

RelatedPerson.period

Short	Period of time that this relationship is considered valid
Definition	The period of time during which this relationship is or was active. If there are no dates defined, then the interval is unknown.
Cardinality	0..1
Type	Period
Invariants	ele-1

RelatedPerson.communication

Short	A language which may be used to communicate with about the patient's health
Definition	A language which may be used to communicate with about the patient's health.
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.
Cardinality	0..*
Type	BackboneElement
Invariants	ele-1

RelatedPerson.communication.id

Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	http://hl7.org/fhirpath/System.String

RelatedPerson.communication.extension

Short	Additional content defined by implementations
Definition	May 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.
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.
Cardinality	0..*
Type	Extension
Invariants	ele-1, ext-1
Also called	extensions, user content

RelatedPerson.communication.modifierExtension

Short	Extensions that cannot be ignored even if unrecognized
Definition	May 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).
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.
Cardinality	0..*
Type	Extension
Modifier	yes — Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Invariants	ele-1, ext-1
Also called	extensions, user content, modifiers

RelatedPerson.communication.language

Short	The language which can be used to communicate with the patient about his or her health
Definition	The 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.
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.
Cardinality	1..1
Type	CodeableConcept
Binding	languages (preferred)
Invariants	ele-1

RelatedPerson.communication.preferred

Short	Language preference indicator
Definition	Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
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.
Cardinality	0..1
Type	boolean
Invariants	ele-1