Modelling Dependent and Family Relationshps

Hi Everyone,

I’m looking for some advice in modelling Dependents (minor as well as adult dependents) as well as family relationships in FHIR.

I have some specific requirements:

  1. Add minor dependents and relate them to an existing patient or to a non-patient
  2. Transition the dependent to an adult
  3. Add an adult dependent to an existing patient or to a non-patient
  4. Transition a dependent as an adult dependent
  5. Maintain family relationships. Person A is a child of Person B

My understanding is that RelatedPerson can be used to model all of these relationships except the family relationship. How would I model Person A as minor dependent of Person B and then transition Person A as an adult (on attaining adulthood) while at the same time maintaining that Person A is related to Person B?

As there any best practices that I should follow?


The trick with RelatedPerson is that it’s “owned” by a single patient record. If you have two people in your system as Patients and they happen to be related to each other, then you’ll have two Patient instances and two RelatedPerson instances. E.g. Mom and RelatedPerson to child in mom’s record and Child and RelatedPerson to mom in child’s record. There won’t typically be a link from “RelatedPersonMom” to “PatientMom”, though you can accomplish this with an extension. You can also have a Person instance that asserts that RelatedPersonMom and PatientMom are the same human being and use it to maintain shared demographics.

In your scenario Person A is, first and foremost, a Patient. The fact they have an “is dependent” relationship to some other person is secondary. They will remain a Patient when they reach the age of majority. The relationship will simply go away (or have its status change).

Note that it’s possible for a RelatedPerson to have multiple relationships - so you can say “mother” and “neighbor” and “guardian”. If the guardian bit ends, the RelatedPerson would stay, you’d just drop one of the relationship types.