RelatedPerson — detail: patient relative
Representation of persons linked to the patient without being patients themselves: next of kin, healthcare proxy (Loi Kouchner 2002 in FR, HPOA in US), family caregiver, guardian, child's parent. Strict distinction from Patient (who receives care) and Person (cross-domain registry).
RelatedPerson vs Patient vs Person
Critical conceptual distinction to avoid duplicates and business errors:
- Patient — person receiving care. Medical record subject.
- RelatedPerson — person linked to a patient, with no clinical role. Always attached to a Patient. No own medical record.
- Person — cross-domain registry that links multiple resources (Patient, Practitioner, RelatedPerson) for the same physical person. Used in EMPI.
If a relative becomes a patient (consults for themselves), create a distinct Patient and link the two via Person.
Key fields
| Field | Cardinality | Role |
|---|---|---|
active | 0..1 | Active link (true by default). |
patient | 1..1 | Linked patient (mandatory). |
relationship | 0..* | Nature(s) of the link (v3-RoleCode + local codes). |
name | 0..* | Name (HumanName). |
telecom | 0..* | Phone, email with rank (priority). |
gender | 0..1 | male / female / other / unknown. |
birthDate | 0..1 | Birth date (useful for identification + adulthood). |
address | 0..* | Address(es). |
period | 0..1 | Link validity period (useful for transient relations). |
communication | 0..* | Preferred language(s) for communication (BCP-47). |
Healthcare proxy / health care surrogate
Most jurisdictions recognize a designated proxy for medical decisions when the patient cannot express themselves:
- US — Healthcare Power of Attorney (HPOA), Living Will, Surrogate Decision Maker (state laws vary).
- France — Personne de confiance (Loi Kouchner 2002, article L1111-6 CSP).
- UK — Lasting Power of Attorney for Health and Welfare (Mental Capacity Act 2005).
In FHIR, modelled via relationship with both v3-RoleCode HPOWATT (or jurisdiction-specific code) and a local code if applicable.
Example: spouse healthcare proxy
{
"resourceType": "RelatedPerson",
"id": "rp-spouse-marie-887",
"active": true,
"patient": { "reference": "Patient/marie-durand-887" },
"relationship": [{
"coding": [{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "SPS",
"display": "Spouse"
}]
}, {
"coding": [{
"system": "http://hl7.org/fhir/CodeSystem/v3-RoleCode",
"code": "HPOWATT",
"display": "Healthcare power of attorney"
}]
}],
"name": [{
"use": "official",
"family": "DURAND",
"given": ["JEAN", "MICHEL"]
}],
"telecom": [{
"system": "phone",
"value": "+33 6 12 34 56 78",
"use": "mobile",
"rank": 1
}, {
"system": "email",
"value": "jean.durand@example.fr",
"use": "home",
"rank": 2
}],
"gender": "male",
"birthDate": "1976-08-15",
"address": [{
"use": "home",
"line": ["12 RUE DE LA PAIX"],
"postalCode": "75002",
"city": "PARIS",
"country": "FR"
}],
"period": {
"start": "2010-06-15"
},
"communication": [{
"language": {
"coding": [{
"system": "urn:ietf:bcp:47",
"code": "fr-FR",
"display": "French (France)"
}]
},
"preferred": true
}]
}Common pitfalls
- Next-of-kin confused with healthcare proxy — two legally distinct concepts. Next-of-kin = administrative emergency contact; proxy = consulted for medical decisions.
- RelatedPerson created for self — error in fast entry: a relative becomes patient and is created twice (once as RelatedPerson, once as Patient). Enable EMPI Person.
- period not closed — a deceased parent should have
active=false+period.end. Otherwise IT reports include stale contacts. - Too many relationships — same RelatedPerson can have multiple roles (spouse + healthcare proxy + caregiver). List all explicitly for GDPR/medical audit.