Path | Short | Definition | Comments |
---|---|---|---|
A generic person record | Demographics and administrative information about a person independent of a specific health-related context. | The Person resource does justice to person registries that keep track of persons regardless of their role. The Person resource is also a primary resource to point to for people acting in a particular role such as SubjectofCare, Practitioner, and Agent. Very few attributes are specific to any role and so Person is kept lean. Most attributes are expected to be tied to the role the Person plays rather than the Person himself. Examples of that are Guardian (SubjectofCare), ContactParty (SubjectOfCare, Practitioner), and multipleBirthInd (SubjectofCare). | |
identifier | A human identifier for this person | Identifier for a person within a particular scope. | |
name | A name associated with the person | A name associated with the person. | Person may have multiple names with different uses or applicable periods. |
telecom | A contact detail for the person | A contact detail for the person, e.g. a telephone number or an email address. | 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. |
gender | male | female | other | unknown | Administrative Gender. | The gender might not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though a clear majority of systems and contexts only support M and F. |
birthDate | The date on which the person was born | The birth date for the person. | At least an estimated year should be provided as a guess if the real DOB is unknown. |
address | One or more addresses for the person | One or more addresses for the person. | Person may have multiple addresses with different uses or applicable periods. |
photo | Image of the person | An image that can be displayed as a thumbnail of the person to enhance the identification of the individual. | |
managingOrganization | The organization that is the custodian of the person record | The organization that is the custodian of the person record. | |
active | This person's record is in active use | Whether this person's record is in active use. | |
link | Link to a resource that concerns the same actual person | Link to a resource that concerns the same actual person. | |
link.id | Unique id for inter-element referencing | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
link.extension | Additional content defined by implementations | 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. | 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. |
link.modifierExtension | Extensions that cannot be ignored even if unrecognized | 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). | 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. |
link.target | The resource to which this actual person is associated | The resource to which this actual person is associated. | |
link.assurance | level1 | level2 | level3 | level4 | Level of assurance that this link is associated with the target resource. |
The Person resource serves as a linkage resource that may provide a reference set of common demographics
for an individual (human or animal) across multiple roles.
This linkage can be direct to role-specific FHIR resources (Patient, Practitioner and RelatedPerson)
residing on the same or possibly distinct FHIR systems/applications, or indirectly through the use of
business identifiers.
The Person resource may be used in many situations/contexts, including:
Note: The Person resource is an advanced feature. Many systems don’t have a way to relate information across resource types, or systems, especially from Patient to Practitioner, and therefore might not implement this functionality. Some do have ways of relating the Patient and RelatedPerson resource types. FHIR is also able to do this without the Person resource, utilizing the Patient.link property (as shown in the Mother and newborn relationship example)
Person resources may have references to Patient, RelatedPerson and/or Practitioner resources. These linkages assert that all the records relate to the same individual.
Person instances are never directly referenced as actors (authors, subjects, performers, etc.) Individual actors are always identified as either Patient, Practitioner or RelatedPerson, depending on the role of the individual when undertaking the action. Therefore this resource SHALL NOT be referenced by any other clinical or administrative resources. E.g. it can be the focus of an operation or message or included in a Bundle, but cannot be a member of a List or Group, the subject of an Observation, or other similar non-infrastructural usage.
In some use cases the linkages will be indirect, and through business Identifiers, such as in the case of the various types of Master Person Indexes, where the records are not there for the purpose of healthcare, but simply describing a population of people, and has other purposes and not just to represent a population patients.
Most of the properties of the Person resource are replicated within the other resources that they are shared with. This is intentional and highlights the loose coupling of the resources.
Not many systems implement a shared Person record, and as such the values DO become out of sync with each other. The inclusion of this resource does permit a capability for systems to identify other instances of this actual person's data via a centralized registry that can assist in keeping things up to date.
The link element is used to relate resources under a common person record. This element supports two primary scenarios where other resources refer to the same person resource.
The link element cannot be used to link to RelatedPerson entries, so we can use a Person resource to relate these elements together identifying them as the same individual.
In a data sharing network, finding the location of patient records across different systems is a necessary pre-requisite for accessing external patient data. Using the link element, systems associate patient resources from different organizations. The assuranceLevel associated with the link provides a way for a system to qualify its confidence in the asserted link. For example, a relationship from the person to a patient using a probabilistic matching algorithm may be represented using a link with an assurance level of level1, while a relationship established using a government-issued photo ID may be created with an assurance level of level3.
Similarly, providers working in multiple healthcare service settings may be linked across different organizations using the link element. The various practitioner resources can be related using a common person resource with a link for each of the practitioner resources located in other organizations.
Many national and state programs maintain a central register of people, and their key Identifiers. These systems do not store any health related information, they are purely a validated set data, often provided by government departments. These may contain identifiers for patients, practitioners from various departments for various purposes. Access to these systems typically requires some form of professional role or permission, such as those in healthcare, law enforcement, or other internal government uses.
These may also operate outside of government in the private sector, such as associations or networks that a person may be involved with and may work in the same was as they do inside government. The usage of the data into the healthcare environment is not the only use of the register.
Note: This style of system may use the Person resource without any FHIR references to Patient or Practitioner resources. In these environments the Master Index is likely to have a master identifier that performs this logical linking.
This style of usage has fewer security implications, as it doesn’t disclose where the information is being used.
Client Portals provide consumer access to a window of their data locked up in healthcare systems. In many cases these systems are externally integrated and do not have access to the legacy CIS/PAS systems.
In contrast to most systems where a user has access to multiple patients depending on their roles and permissions,
a client portal provides a consumer with direct access to their data (with permissions applied).
This can also include not just their data (via the Person.link Patient entries), but also to information that they
have entered, or were involved with (via the Person.link RelatedPerson entries), such as observations that they
entered.
With appropriate permissions/consent applied, the user could have access to other Patient records linked via
a RelatedPerson.
The Person resource may contain identifying and demographic information about an individual, therefore it must be protected as Identifying Information.
The Person resource may contain references to the individual's other various Patient, Practitioner,
and RelatedPerson resources, where the referenced record might be to very sensitive information.
The access to the linked sensitive Resource may be protected, but the link itself may expose information.
For example where a Practitioner and Patient resource are linked through a Person resource, inspecting the
Patient URL could reveal that the Practitioner has a record at a sensitive medical health clinic (e.g. Drug Rehabilitation Clinic).
When implementing the Person resource consideration should be given to the security and privacy of this information. Some mitigations to these risks include higher access control protections, filling out the Person resource as sparsely as practical for the given use-cases, and masking some data elements for certain users of the information. Additional security guidance can be found on the security page.
identifier | A person Identifier | Person.identifier |
link | Any link has this Patient, Person, RelatedPerson or Practitioner reference | Person.link.target |
name | A server defined search that may match any of the string fields in the HumanName, including family, give, prefix, suffix, suffix, and/or text | Person.name |
organization | The organization at which this person record is being managed | Person.managingOrganization |
patient | The Person links to this Patient | Person.link.target.where(resolve() is Patient) |
practitioner | The Person links to this Practitioner | Person.link.target.where(resolve() is Practitioner) |
relatedperson | The Person links to this RelatedPerson | Person.link.target.where(resolve() is RelatedPerson) |