| Australian Digital Health Agency FHIR Implementation Guide 1.0.0

Australian Digital Health Agency FHIR Implementation Guide. This is the current published version. It is based on FHIR® version 4.0.1. See the Directory of published versions for a list of available versions.

#### StructureDefinition: ADHA Authoring RelatedPerson - Detailed Descriptions

Definitions for the dh-relatedperson-author-1 Profile.

1. RelatedPerson
Definition | 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. A related person might be a family member, close friend, carer, legal guardian, or someone with enduring power of attorney.
Control | 0..*
Comments | In the context of the My Health Record, a related person may manage another individual's My Health Record as an authorised representative, or they may view or help manage another individual's My Health Record as a nominated representative.
2. RelatedPerson.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
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.
3. RelatedPerson.meta
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.
Control | 0..1
Type | Meta
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. RelatedPerson.implicitRules
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.
Control | 0..1
Type | uri
Is Modifier | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. RelatedPerson.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages A human language
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. RelatedPerson.text
Definition | A 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.
Control | 0..1
Type | Narrative
Alternate Names | narrativehtmlxhtmldisplay
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. RelatedPerson.contained
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.
Control | 0..*
Type | Resource
Alternate Names | inline resourcesanonymous resourcescontained 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.
8. RelatedPerson.extension
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.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser 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 | Defined on this element 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())
9. RelatedPerson.modifierExtension
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).
Control | 0..*
Type | Extension
Is Modifier | true
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.
Alternate Names | extensionsuser 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 | Defined on this element 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())
10. RelatedPerson.identifier
Definition | Identifier for a person within a particular scope.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..* This element is affected by the following invariants: ele-1
Type | Identifier(Identifier AUIHI AUMedicareCardNumber AUDVANumber AUHealthCareCardNumber AUPensionerConcessionCardNumber AUCwlthSeniorsHealthCardNumber AUMedicalRecordNumber AUInsuranceMemberNumber)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on RelatedPerson.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ type
11. RelatedPerson.identifier:ihi
SliceName | ihi
Definition | Individual Healthcare Identifier (IHI) assigned under the HI Service to a patient.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(AUIHI)
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) inv-ihi-value-0: IHI shall be an exactly 16 digit number (: value.matches('^([0-9]{16})$')) inv-ihi-value-1: IHI prefix is 800360 (: value.startsWith('800360')) inv-ihi-value-2: IHI shall pass the Luhn algorithm check (: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger())+(select(value.substring(10,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(11,1).toInteger())+(select(value.substring(12,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(13,1).toInteger())+(select(value.substring(14,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(15,1).toInteger()))mod 10=0))
12. RelatedPerson.identifier:medicare
SliceName | medicare
Definition | Medicare card number as either the the 10 digit Medicare card number or the 11 digit number (includes the individual reference number (IRN)). A Medicare card is provided to individuals who are enrolled in Medicare.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(AUMedicareCardNumber)
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. RelatedPerson.identifier:dva
SliceName | dva
Definition | Department of Veterans’ Affairs (DVA) file number displayed on a Veteran Card.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(AUDVANumber)
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. RelatedPerson.active
Definition | Whether this related person record is in active use.
Control | 0..1
Type | boolean
Is Modifier | true
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.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Fixed Value | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. RelatedPerson.patient
Definition | The patient this person is related to.
Control | 1..1 This element is affected by the following invariants: inv-dh-relper-02
Type | Reference(ADHAPatientCore))
Must Support | true
Requirements | We need to know which patient this RelatedPerson is related to.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) inv-dh-relper-02: At least a reference, identifier or display shall be present (: reference.exists() or identifier.exists() or display.exists())
16. RelatedPerson.relationship
Definition | The nature of the relationship between a patient and the related person.
Control | 1..*
Binding | The codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/related-person-relationship-type-1; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
Requirements | We need to know the relationship with the patient since it influences the interpretation of the information attributed to this person.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. RelatedPerson.name
Definition | A name associated with the person.
Control | 1..* This element is affected by the following invariants: inv-dh-relper-01
Type | HumanName
Must Support | true
Requirements | Related persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. RelatedPerson.telecom
Definition | A contact detail for the person, e.g. a telephone number or an email address.
Control | 1..*
Type | ContactPoint
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. RelatedPerson.gender
Definition | Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes
Type | code
Requirements | Needed for identification of the person, in combination with (at least) name and birth date.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. RelatedPerson.birthDate
Definition | The date on which the related person was born.
Control | 0..1
Type | date
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. RelatedPerson.address
Definition | Address where the related person can be contacted or visited.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Address(Address AustralianAddress)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Need to keep track where the related person can be contacted per postal mail or visited.
Comments | The 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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. RelatedPerson.photo
Definition | Image of the person.
Control | 0..*
Type | Attachment
Requirements | Many EHR systems have the capability to capture an image of persons. Fits with newer social media usage too.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. RelatedPerson.period
Definition | The period of time during which this relationship is or was active. If there are no dates defined, then the interval is unknown.
Control | 0..1
Type | Period
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. RelatedPerson.communication
Definition | A language which may be used to communicate with about the patient's health.
Control | 0..*
Type | BackboneElement
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. RelatedPerson.communication.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
26. RelatedPerson.communication.extension
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.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser 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 | Defined on this element 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())
27. RelatedPerson.communication.modifierExtension
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).
Control | 0..*
Type | Extension
Is Modifier | true
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.
Alternate Names | extensionsuser contentmodifiers
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 | Defined on this element 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())
28. RelatedPerson.communication.language
Definition | A language which can be used to communicate with about the patient's health. 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.
Control | 1..1
Binding | The codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. RelatedPerson.communication.preferred
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Control | 0..1
Type | boolean
Must Support | true
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 | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))