8.37 Resource PersonalRelationship - Content

8.37.1 Scope and Usage

This resource is to be used for any inter-personal relationship, such as but not limited to:

• Represent a marriage or other long-term commitment
• Represent familial relationships
• Represent social interaction relationships that have might or might not proximity, e.g. roommates, team members, classmate
• Represent relationships amongst members of a group but not their involvement or role within the group.

The relevance of recording appropriate relationships would be determined per use case. Implementation guides addressing each scenario would determine those appropriate levels of relevance. For example, a Public Health Implementation Guide may indicate how to represent broad sets of relationships for contact tracing, while a Social Services Implementation Guide may indicate how to represent households for financial assistance program eligibility. Not all relationships are expected to be recorded, but within any scenario any relationship could be categorized as relevant.

The relationship can include a time period associated with it to represent current as well as future and past relationships. This allows for the temporal nature of the relationship. (e.g., father/daughter is mostly persistent, but resident in household is very transient).

Additionally, there is the ability to assert the certainty of the relationship.

This is not for tracking relationships between a care team or provider and the patient. For example, the social worker would be a Practitioner on your Care Team. The PersonalRelationship is not for tracking caregivers that are performing actions. It does not document a role of an individual, just the relationship between individuals. For example, the lady taking you to church would be a RelatedPerson, which is a role.

8.37.1.1 Potential use cases:

• Public Health
• Isolation
• Contact tracing
• WIC programs
• Congregate housing
• 2/15/2024 - Public Health WG has indicated they are interested, and wants to be kept up to date.
• Social Care
• Gravity
• Administration for Children and Families (ACF)
• Occupational Health
• Shared exposures or environments
• Military Health (for representing units)
• First responders
• Research

8.37.2 Boundaries and Relationships

Boundaries between this and RelatedPerson
The RelatedPerson resource contains the details of both the individual and their relationship to the patient. RelatedPerson would be used when the individual is documented within the context of a patient's chart.
RelatedPerson can be an actor and do things. PersonalRelationship cannot do things. PersonalRelationship is one way you can discover someone who can do things. A PersonalRelationship does not automatically indicate that the target individual might NOT be assumed to take actions on behalf of a source individual.

Boundaries between this and FamilyMemberHistory
Although there is a relationship within the family member history, it is not the same as the relationship. It intends to provide the details of the family member's health history that could be relevant to the patient, not the relationship itself.

Boundaries between this and CareTeam
PersonalRelationship is not to be used to represent the relationship of "provides care for". That should be in CareTeam.

Boundaries between this and Group
A group contains all the members and the involvement property indicates the member's relationship to the group, not to the other individuals withing the group.

Boundaries between this and Person.link
Some systems have a situation where they have a single record of a one individual that is related to multiple patients, and can perform actions for each of those patients. For example, a mother (who is not a Patient) of two children (who are both Patients). The intent is that this be modeled in FHIR by using multiple RelatedPerson resources that all represent the same record for human individual. For the mother / two chidlren example, you would have two RelatedPerson resources, both representing the mother. Each RelatedPerson resource would refer to the Patient resources for the two children. PersonalRelationship should not be used to indicate that those RelatedPerson resources represent the same individual. Instead, those different RelatedPerson resources can be linked using Person.link.

• Structure
• UML
• XML
• JSON
• Turtle
• R4 Diff
• All

Structure

Name	Flags	Card.	Type	Description & Constraints
PersonalRelationship	D		DomainResource	A relationship between two indiduals Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
source	Σ	1..1	Reference(Patient | RelatedPerson | Person)	The individual that is the the source of the relationship
relationshipType	Σ	1..1	CodeableConcept	The relationship between the source and the target individuals Binding: Personal Relationship Type (Preferred)
target	Σ	1..1	Reference(Patient | RelatedPerson | Person)	The individual that is the the target of the relationship
period		0..*	Period	The period of time during which the relationship is active
confidence	Σ	0..1	CodeableConcept	The confidence level of this relationship Binding: Confidence (Example)
asserter		0..1	Reference(Patient | RelatedPerson | Practitioner | Organization)	Who has asserted the details of the relationship
group	Σ	0..*	Reference(Group)	This relationship is applicable to the referenced group(s)
Documentation for this format

See the Extensions for this resource

<PersonalRelationship xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <source><!-- 1..1 Reference(Patient|Person|RelatedPerson) The individual that is the the source of the relationship --></source>
 <relationshipType><!-- 1..1 CodeableConcept The relationship between the source and the target individuals --></relationshipType>
 <target><!-- 1..1 Reference(Patient|Person|RelatedPerson) The individual that is the the target of the relationship --></target>
 <period><!-- 0..* Period The period of time during which the relationship is active --></period>
 <confidence><!-- 0..1 CodeableConcept The confidence level of this relationship --></confidence>
 <asserter><!-- 0..1 Reference(Organization|Patient|Practitioner|RelatedPerson) Who has asserted the details of the relationship --></asserter>
 <group><!-- 0..* Reference(Group) This relationship is applicable to the referenced group(s) --></group>
</PersonalRelationship>

{
  "resourceType" : "PersonalRelationship",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "source" : { Reference(Patient|Person|RelatedPerson) }, // R!  The individual that is the the source of the relationship
  "relationshipType" : { CodeableConcept }, // R!  The relationship between the source and the target individuals
  "target" : { Reference(Patient|Person|RelatedPerson) }, // R!  The individual that is the the target of the relationship
  "period" : [{ Period }], // The period of time during which the relationship is active
  "confidence" : { CodeableConcept }, // The confidence level of this relationship
  "asserter" : { Reference(Organization|Patient|Practitioner|RelatedPerson) }, // Who has asserted the details of the relationship
  "group" : [{ Reference(Group) }] // This relationship is applicable to the referenced group(s)
}

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:PersonalRelationship;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:source [ Reference(Patient|Person|RelatedPerson) ] ; # 1..1 The individual that is the the source of the relationship
  fhir:relationshipType [ CodeableConcept ] ; # 1..1 The relationship between the source and the target individuals
  fhir:target [ Reference(Patient|Person|RelatedPerson) ] ; # 1..1 The individual that is the the target of the relationship
  fhir:period  ( [ Period ] ... ) ; # 0..* The period of time during which the relationship is active
  fhir:confidence [ CodeableConcept ] ; # 0..1 The confidence level of this relationship
  fhir:asserter [ Reference(Organization|Patient|Practitioner|RelatedPerson) ] ; # 0..1 Who has asserted the details of the relationship
  fhir:group  ( [ Reference(Group) ] ... ) ; # 0..* This relationship is applicable to the referenced group(s)
]

Structure

Name	Flags	Card.	Type	Description & Constraints
PersonalRelationship	D		DomainResource	A relationship between two indiduals Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
source	Σ	1..1	Reference(Patient | RelatedPerson | Person)	The individual that is the the source of the relationship
relationshipType	Σ	1..1	CodeableConcept	The relationship between the source and the target individuals Binding: Personal Relationship Type (Preferred)
target	Σ	1..1	Reference(Patient | RelatedPerson | Person)	The individual that is the the target of the relationship
period		0..*	Period	The period of time during which the relationship is active
confidence	Σ	0..1	CodeableConcept	The confidence level of this relationship Binding: Confidence (Example)
asserter		0..1	Reference(Patient | RelatedPerson | Practitioner | Organization)	Who has asserted the details of the relationship
group	Σ	0..*	Reference(Group)	This relationship is applicable to the referenced group(s)
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<PersonalRelationship xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <source><!-- 1..1 Reference(Patient|Person|RelatedPerson) The individual that is the the source of the relationship --></source>
 <relationshipType><!-- 1..1 CodeableConcept The relationship between the source and the target individuals --></relationshipType>
 <target><!-- 1..1 Reference(Patient|Person|RelatedPerson) The individual that is the the target of the relationship --></target>
 <period><!-- 0..* Period The period of time during which the relationship is active --></period>
 <confidence><!-- 0..1 CodeableConcept The confidence level of this relationship --></confidence>
 <asserter><!-- 0..1 Reference(Organization|Patient|Practitioner|RelatedPerson) Who has asserted the details of the relationship --></asserter>
 <group><!-- 0..* Reference(Group) This relationship is applicable to the referenced group(s) --></group>
</PersonalRelationship>

JSON Template

{
  "resourceType" : "PersonalRelationship",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "source" : { Reference(Patient|Person|RelatedPerson) }, // R!  The individual that is the the source of the relationship
  "relationshipType" : { CodeableConcept }, // R!  The relationship between the source and the target individuals
  "target" : { Reference(Patient|Person|RelatedPerson) }, // R!  The individual that is the the target of the relationship
  "period" : [{ Period }], // The period of time during which the relationship is active
  "confidence" : { CodeableConcept }, // The confidence level of this relationship
  "asserter" : { Reference(Organization|Patient|Practitioner|RelatedPerson) }, // Who has asserted the details of the relationship
  "group" : [{ Reference(Group) }] // This relationship is applicable to the referenced group(s)
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:PersonalRelationship;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:source [ Reference(Patient|Person|RelatedPerson) ] ; # 1..1 The individual that is the the source of the relationship
  fhir:relationshipType [ CodeableConcept ] ; # 1..1 The relationship between the source and the target individuals
  fhir:target [ Reference(Patient|Person|RelatedPerson) ] ; # 1..1 The individual that is the the target of the relationship
  fhir:period  ( [ Period ] ... ) ; # 0..* The period of time during which the relationship is active
  fhir:confidence [ CodeableConcept ] ; # 0..1 The confidence level of this relationship
  fhir:asserter [ Reference(Organization|Patient|Practitioner|RelatedPerson) ] ; # 0..1 Who has asserted the details of the relationship
  fhir:group  ( [ Reference(Group) ] ... ) ; # 0..* This relationship is applicable to the referenced group(s)
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.