2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

4.29 Resource FamilyHistory - Content

This resource maintained by the Patient Care Work Group

Significant health events and conditions for people related to the subject relevant in the context of care for the subject.

4.29.1 Scope and Usage

This resource records significant health events and conditions for people related to the subject. This information can be known to different levels of accuracy. Sometimes the exact condition ('asthma') is known, and sometimes it is less precise ('some sort of cancer'). Equally, sometimes the person can be identified ('my aunt Agatha') and sometimes all that is known is that the person was an uncle.

This resource represents a simple structure used to capture an 'elementary' family history. However, it can also be the basis for capturing a more rigorous history useful for genetic and other analysis - refer to the Genetic Pedigree profile for an example.

The entire family history for an individual is stored in a single resource.

This resource is referenced by ClinicalAssessment and Procedure

4.29.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyHistory DomainResourceInformation about patient's relatives, relevant for patient
... identifier Σ0..*IdentifierExternal Id(s) for this record
... patient Σ1..1PatientPatient history is about
... date Σ0..1dateTimeWhen history was captured/updated
... note 0..1stringAdditional details not covered elsewhere
... relation I0..*ElementRelative described by history
Can have age[x] or birth[x], but not both
.... name Σ0..1stringThe family member described
.... relationship Σ1..1CodeableConceptRelationship to the subject
FamilialRelationship (Incomplete)
.... born[x] I(approximate) date of birth
..... bornPeriod0..1Period
..... bornDate0..1date
..... bornString0..1string
.... age[x] I(approximate) age
..... ageAge0..1Age
..... ageRange0..1Range
..... ageString0..1string
.... deceased[x] Dead? How old/when?
..... deceasedBoolean0..1boolean
..... deceasedAge0..1Age
..... deceasedRange0..1Range
..... deceasedDate0..1date
..... deceasedString0..1string
.... note 0..1stringGeneral note about related person
.... condition 0..*ElementCondition that the related person had
..... type 1..1CodeableConceptCondition suffered by relation
..... outcome 0..1CodeableConceptdeceased | permanent disability | etc.
..... onset[x] When condition first manifested
...... onsetAge0..1Age
...... onsetRange0..1Range
...... onsetString0..1string
..... note 0..1stringExtra information about condition

UML Diagram

FamilyHistory (DomainResource)This records identifiers associated with this family history record that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)identifier : Identifier 0..*The person who this history concernspatient : Reference(Patient) 1..1The date (and possibly time) when the family history was takendate : dateTime 0..1Conveys information about family history not specific to individual relationsnote : string 0..1RelationThis will either be a name or a description. E.g. "Aunt Susan", "my cousin with the red hair"name : string 0..1The type of relationship this person has to the patient (father, mother, brother etc.)relationship : CodeableConcept 1..1 « The nature of the relationship between the patient and the related person being described in the family historyFamilialRelationship+ »The actual or approximate date of birth of the relativeborn[x] : Period|date|string 0..1The actual or approximate age of the relative at the time the family history is recordedage[x] : Age|Range|string 0..1If this resource is indicating that the related person is deceased, then an indicator of whether the person is deceased (yes) or not (no) or the age or age range or description of age at death - can be indicated here. If the reason for death is known, then it can be indicated in the outcome code of the condition - in this case the deceased property should still be setdeceased[x] : boolean|Age|Range|date|string 0..1This property allows a non condition-specific note to the made about the related person. Ideally, the note would be in the condition property, but this is not always possiblenote : string 0..1ConditionThe actual condition specified. Could be a coded condition (like MI or Diabetes) or a less specific string like 'cancer' depending on how much is known about the condition and the capabilities of the creating systemtype : CodeableConcept 1..1Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept 0..1Either the age of onset, range of approximate age or descriptive string can be recorded. For conditions with multiple occurrences, this describes the first known occurrenceonset[x] : Age|Range|string 0..1An area where general notes can be placed about this specific conditionnote : string 0..1The significant Conditions (or condition) that the family member had. This is a repeating section to allow a system to represent more than one condition per resource, though there is nothing stopping multiple resources - one per conditioncondition0..*The related person. Each FamilyHistory resource contains the entire family history for a single personrelation0..*

XML Template

<FamilyHistory xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was captured/updated -->
 <note value="[string]"/><!-- 0..1 Additional details not covered elsewhere -->
 <relation>  <!-- 0..* Relative described by history -->
  <name value="[string]"/><!-- 0..1 The family member described -->
  <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
  <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
  <age[x]><!-- ?? 0..1 Age|Range|string (approximate) age --></age[x]>
  <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
  <note value="[string]"/><!-- 0..1 General note about related person -->
  <condition>  <!-- 0..* Condition that the related person had -->
   <type><!-- 1..1 CodeableConcept Condition suffered by relation --></type>
   <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
   <onset[x]><!-- 0..1 Age|Range|string When condition first manifested --></onset[x]>
   <note value="[string]"/><!-- 0..1 Extra information about condition -->
  </condition>
 </relation>
</FamilyHistory>

JSON Template

{doco
  "resourceType" : "FamilyHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "patient" : { Reference(Patient) }, // R! Patient history is about
  "date" : "<dateTime>", // When history was captured/updated
  "note" : "<string>", // Additional details not covered elsewhere
  "relation" : [{ // Relative described by history
    "name" : "<string>", // The family member described
    "relationship" : { CodeableConcept }, // R! Relationship to the subject
    // born[x]: (approximate) date of birth. One of these 3:
    "bornPeriod" : { Period },
    "bornDate" : "<date>",
    "bornString" : "<string>",
    // age[x]: (approximate) age. One of these 3:
    "ageAge" : { Age },
    "ageRange" : { Range },
    "ageString" : "<string>",
    // deceased[x]: Dead? How old/when?. One of these 5:
    "deceasedBoolean" : <boolean>,
    "deceasedAge" : { Age },
    "deceasedRange" : { Range },
    "deceasedDate" : "<date>",
    "deceasedString" : "<string>",
    "note" : "<string>", // General note about related person
    "condition" : [{ // Condition that the related person had
      "type" : { CodeableConcept }, // R! Condition suffered by relation
      "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
      // onset[x]: When condition first manifested. One of these 3:
      "onsetAge" : { Age },
      "onsetRange" : { Range },
      "onsetString" : "<string>",
      "note" : "<string>" // Extra information about condition
    }]
  }]
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyHistory DomainResourceInformation about patient's relatives, relevant for patient
... identifier Σ0..*IdentifierExternal Id(s) for this record
... patient Σ1..1PatientPatient history is about
... date Σ0..1dateTimeWhen history was captured/updated
... note 0..1stringAdditional details not covered elsewhere
... relation I0..*ElementRelative described by history
Can have age[x] or birth[x], but not both
.... name Σ0..1stringThe family member described
.... relationship Σ1..1CodeableConceptRelationship to the subject
FamilialRelationship (Incomplete)
.... born[x] I(approximate) date of birth
..... bornPeriod0..1Period
..... bornDate0..1date
..... bornString0..1string
.... age[x] I(approximate) age
..... ageAge0..1Age
..... ageRange0..1Range
..... ageString0..1string
.... deceased[x] Dead? How old/when?
..... deceasedBoolean0..1boolean
..... deceasedAge0..1Age
..... deceasedRange0..1Range
..... deceasedDate0..1date
..... deceasedString0..1string
.... note 0..1stringGeneral note about related person
.... condition 0..*ElementCondition that the related person had
..... type 1..1CodeableConceptCondition suffered by relation
..... outcome 0..1CodeableConceptdeceased | permanent disability | etc.
..... onset[x] When condition first manifested
...... onsetAge0..1Age
...... onsetRange0..1Range
...... onsetString0..1string
..... note 0..1stringExtra information about condition

UML Diagram

FamilyHistory (DomainResource)This records identifiers associated with this family history record that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)identifier : Identifier 0..*The person who this history concernspatient : Reference(Patient) 1..1The date (and possibly time) when the family history was takendate : dateTime 0..1Conveys information about family history not specific to individual relationsnote : string 0..1RelationThis will either be a name or a description. E.g. "Aunt Susan", "my cousin with the red hair"name : string 0..1The type of relationship this person has to the patient (father, mother, brother etc.)relationship : CodeableConcept 1..1 « The nature of the relationship between the patient and the related person being described in the family historyFamilialRelationship+ »The actual or approximate date of birth of the relativeborn[x] : Period|date|string 0..1The actual or approximate age of the relative at the time the family history is recordedage[x] : Age|Range|string 0..1If this resource is indicating that the related person is deceased, then an indicator of whether the person is deceased (yes) or not (no) or the age or age range or description of age at death - can be indicated here. If the reason for death is known, then it can be indicated in the outcome code of the condition - in this case the deceased property should still be setdeceased[x] : boolean|Age|Range|date|string 0..1This property allows a non condition-specific note to the made about the related person. Ideally, the note would be in the condition property, but this is not always possiblenote : string 0..1ConditionThe actual condition specified. Could be a coded condition (like MI or Diabetes) or a less specific string like 'cancer' depending on how much is known about the condition and the capabilities of the creating systemtype : CodeableConcept 1..1Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept 0..1Either the age of onset, range of approximate age or descriptive string can be recorded. For conditions with multiple occurrences, this describes the first known occurrenceonset[x] : Age|Range|string 0..1An area where general notes can be placed about this specific conditionnote : string 0..1The significant Conditions (or condition) that the family member had. This is a repeating section to allow a system to represent more than one condition per resource, though there is nothing stopping multiple resources - one per conditioncondition0..*The related person. Each FamilyHistory resource contains the entire family history for a single personrelation0..*

XML Template

<FamilyHistory xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was captured/updated -->
 <note value="[string]"/><!-- 0..1 Additional details not covered elsewhere -->
 <relation>  <!-- 0..* Relative described by history -->
  <name value="[string]"/><!-- 0..1 The family member described -->
  <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
  <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
  <age[x]><!-- ?? 0..1 Age|Range|string (approximate) age --></age[x]>
  <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
  <note value="[string]"/><!-- 0..1 General note about related person -->
  <condition>  <!-- 0..* Condition that the related person had -->
   <type><!-- 1..1 CodeableConcept Condition suffered by relation --></type>
   <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
   <onset[x]><!-- 0..1 Age|Range|string When condition first manifested --></onset[x]>
   <note value="[string]"/><!-- 0..1 Extra information about condition -->
  </condition>
 </relation>
</FamilyHistory>

JSON Template

{doco
  "resourceType" : "FamilyHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "patient" : { Reference(Patient) }, // R! Patient history is about
  "date" : "<dateTime>", // When history was captured/updated
  "note" : "<string>", // Additional details not covered elsewhere
  "relation" : [{ // Relative described by history
    "name" : "<string>", // The family member described
    "relationship" : { CodeableConcept }, // R! Relationship to the subject
    // born[x]: (approximate) date of birth. One of these 3:
    "bornPeriod" : { Period },
    "bornDate" : "<date>",
    "bornString" : "<string>",
    // age[x]: (approximate) age. One of these 3:
    "ageAge" : { Age },
    "ageRange" : { Range },
    "ageString" : "<string>",
    // deceased[x]: Dead? How old/when?. One of these 5:
    "deceasedBoolean" : <boolean>,
    "deceasedAge" : { Age },
    "deceasedRange" : { Range },
    "deceasedDate" : "<date>",
    "deceasedString" : "<string>",
    "note" : "<string>", // General note about related person
    "condition" : [{ // Condition that the related person had
      "type" : { CodeableConcept }, // R! Condition suffered by relation
      "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
      // onset[x]: When condition first manifested. One of these 3:
      "onsetAge" : { Age },
      "onsetRange" : { Range },
      "onsetString" : "<string>",
      "note" : "<string>" // Extra information about condition
    }]
  }]
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

4.29.2.1 Terminology Bindings

PathDefinitionTypeReference
FamilyHistory.relation.relationship The nature of the relationship between the patient and the related person being described in the family historyIncompletehttp://hl7.org/fhir/v3/vs/FamilyMember
FamilyHistory.relation.condition.outcome The result of the condition for the patient. E.g. death, permanent disability, temporary disability, etc.UnknownNo details provided yet

4.29.2.2 Constraints

  • fhs-1: On FamilyHistory.relation: Can have age[x] or birth[x], but not both (xpath on f:FamilyHistory/f:relation: not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')]))

4.29.3 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
datedateWhen history was captured/updatedFamilyHistory.date
patientreferenceThe identity of a subject to list family history items forFamilyHistory.patient
(Patient)