type: resourceresource: Person

Person

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:

A set of demographics that can be used to co-ordinate the maintenance of this de-normalized information across practitioners, patients and/or related persons
e.g. link known resources of the different types together within a system
A state/network based Master Person Index
e.g. A National Identifier Index or a Network membership/subscriber list
A central register that links patient resources from multiple servers, indicating they all correspond to the same individual
e.g. Within a large organization with many systems to be able to link the various records, without having to modify the source information with external links
A support for access monitoring software that is able to assert what practitioner, patient and related person records correspond to the same human being to assist in detecting improper querying.
e.g. asserting that a Patient A is the same individual as a RelatedPerson B who is related to Patient C, who is also Practitioner D. As such, monitoring for Practitioner D’s accesses to Patient A’s records should be carefully scrutinized.
Local record(s) on a mobile device listing links to remote server patient resources
e.g. A mobile phone application storing references to the hospitals they have access to

[%stu-note advanced%] 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) [%end-note%]

Boundaries and Relationships

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.
Note that the usage of Practitioner is broader in FHIR than the term may suggest, and can encompass individuals who are not licensed healthcare practitioners.

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.

Background and Context

Provides additional detail on exactly how the resource is to be used

Notes

De-normalized Data

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.

Person and Linking

The person.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.

[%stu-note linking1%] In previous versions of the FHIR specification the patient.link element was not able link to RelatedPerson entries, leaving the Person resource to link them. Since STU3 the patient.link property was updated to also support RelatedPerson, reducing the need to link using the Person resource, however this can still be done. [%end-note%]

Cross-Domain Patient Directory

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.

Cross-Domain Provider Directory

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.

Person Master Index

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 healthcare 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.

[%stu-note system%] 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. [%end-note%]

Client Portal

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.

Security and Privacy Considerations

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.

StructureDefinition

Elements (Simplified)

Person [0..*]: - A generic person record
Person.identifier [0..*]: Identifier A human identifier for this person
Person.active [0..1]: boolean This person's record is in active use
Person.name [0..*]: HumanName A name associated with the person
Person.telecom [0..*]: ContactPoint A contact detail for the person
Person.gender [0..1]: code required:administrative-gender male | female | other | unknown
Person.birthDate [0..1]: date The date on which the person was born
Person.deceased[x] [0..1]: boolean, dateTime Indicates if the individual is deceased or not
Person.address [0..*]: Address One or more addresses for the person
Person.maritalStatus [0..1]: CodeableConcept extensible:marital-status Marital (civil) status of a person
Person.photo [0..*]: Attachment Image of the person
Person.communication [0..*]: BackboneElement A language which may be used to communicate with the person about his or her health
Person.communication.language [1..1]: CodeableConcept required:all-languages The language which can be used to communicate with the person about his or her health
Person.communication.preferred [0..1]: boolean Language preference indicator
Person.managingOrganization [0..1]: Reference(Organization) The organization that is the custodian of the person record
Person.link [0..*]: BackboneElement Link to a resource that concerns the same actual person
Person.link.target [1..1]: [Reference(Patient](/Reference(Patient), Practitioner, RelatedPerson, Person)) The resource to which this actual person is associated
Person.link.assurance [0..1]: code required:identity-assuranceLevel level1 | level2 | level3 | level4

Mappings

Person Mappings — 32 mapping entries

Resource Packs

list-Person-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir">
  <id value="Person-packs"/>
  <status value="current"/>
  <mode value="working"/>
</List>

Search Parameters

address — string — A server defined search that may match any of the string fields in the Address, including line, city, district, state, country, postalCode, and/or text — Person.address
address-city — string — A city specified in an address — Person.address.city
address-country — string — A country specified in an address — Person.address.country
address-postalcode — string — A postal code specified in an address — Person.address.postalCode
address-state — string — A state specified in an address — Person.address.state
address-use — token — A use code specified in an address — Person.address.use
birthdate — date — The person's date of birth — Person.birthDate
email — token — A value in an email contact — Person.telecom.where(system='email')
gender — token — The gender of the person — Person.gender
identifier — token — A person Identifier — Person.identifier
link — reference — Any link has this Patient, Person, RelatedPerson or Practitioner reference — Person.link.target
name — string — 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 — reference — The organization at which this person record is being managed — Person.managingOrganization
patient — reference — The Person links to this Patient — Person.link.target.where(resolve() is Patient)
phone — token — A value in a phone contact — Person.telecom.where(system='phone')
phonetic — string — A portion of name using some kind of phonetic matching algorithm — Person.name
practitioner — reference — The Person links to this Practitioner — Person.link.target.where(resolve() is Practitioner)
relatedperson — reference — The Person links to this RelatedPerson — Person.link.target.where(resolve() is RelatedPerson)
telecom — token — The value in any kind of contact — Person.telecom
family — string — A portion of the family name of the person — Person.name.family
given — string — A portion of the given name of the person — Person.name.given
death-date — date — The date of death has been provided and satisfies this search value — (Person.deceased.ofType(dateTime))
deceased — token — This person has been marked as deceased, or has a death date entered — Person.deceased.exists() and Person.deceased != false

Full Search Parameters

Examples

example — person-example — General Person Example
f002 — person-example-f002-ariadne — Same person from RelatedPerson
grahame — person-grahame — Grahame's person resource
pd — person-provider-directory — Provider Directory Example
per4 — person-example-per4 — Deceased Person (details also in patient)
person-example — person-example
person-example-f002-ariadne — person-example-f002-ariadne
person-example-per4 — person-example-per4
person-examples-header — person-examples-header
pp — person-patient-portal — Patient Portal Example

Full Examples

FiveWs.what — Unknown
FiveWs.recorded — Unknown
FiveWs.author — Unknown
FiveWs.actor — Unknown
FiveWs.cause — Unknown
FiveWs.version — Unknown
FiveWs.witness — Unknown
FiveWs.class — Unknown
FiveWs.where — Unknown
FiveWs.context — Unknown
FiveWs.init — Unknown
FiveWs.why — Unknown
FiveWs.source — Unknown
FiveWs.who — Unknown
FiveWs.grade — Unknown
FiveWs.planned — Unknown
FiveWs.done — Unknown
FiveWs.subject — Unknown