Connectathon 11 Snapshot

This page is part of the FHIR Specification (v1.2.0: STU 3 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 . Page versions: R5 R4B R4 R3 R2

4.37 Resource FamilyMemberHistory - Content

Patient Care Work GroupMaturity Level: 1Compartments: Patient

Significant health events and conditions for a person related to the patient relevant in the context of care for the patient.

4.37.1 Scope and Usage

This resource records significant health events and conditions for a particular individual 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 for a particular family member. 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 can be represented by combining references to FamilyMemberHistory instances into a List resource instance.

This resource is referenced by clinicalimpression

4.37.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyMemberHistory IDomainResourceInformation about patient's relatives, relevant for patient
Can have age[x] or born[x], but not both
... identifier 0..*IdentifierExternal Id(s) for this record
... patient Σ1..1Reference(Patient)Patient history is about
... date Σ0..1dateTimeWhen history was captured/updated
... status ?! Σ1..1codepartial | completed | entered-in-error | health-unknown
FamilyHistoryStatus (Required)
... name Σ0..1stringThe family member described
... relationship Σ1..1CodeableConceptRelationship to the subject
FamilyMember (Example)
... gender Σ0..1codemale | female | other | unknown
AdministrativeGender (Required)
... born[x] I0..1(approximate) date of birth
.... bornPeriodPeriod
.... bornDatedate
.... bornStringstring
... age[x] I0..1(approximate) age
.... ageQuantityAge
.... ageRangeRange
.... ageStringstring
... deceased[x] 0..1Dead? How old/when?
.... deceasedBooleanboolean
.... deceasedQuantityAge
.... deceasedRangeRange
.... deceasedDatedate
.... deceasedStringstring
... note 0..1AnnotationGeneral note about related person
... condition 0..*BackboneElementCondition that the related person had
.... code 1..1CodeableConceptCondition suffered by relation
Condition/Problem/Diagnosis Codes (Example)
.... outcome 0..1CodeableConceptdeceased | permanent disability | etc.
Condition Outcome Codes (Example)
.... onset[x] 0..1When condition first manifested
..... onsetQuantityAge
..... onsetRangeRange
..... onsetPeriodPeriod
..... onsetStringstring
.... note 0..1AnnotationExtra information about condition

doco Documentation for this format

UML Diagram

FamilyMemberHistory (DomainResource)This records identifiers associated with this family member 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 [1..1] « Patient »The date (and possibly time) when the family member history was takendate : dateTime [0..1]A code specifying a state of a Family Member History record (this element modifies the meaning of other elements)status : code [1..1] « A code that identifies the status of the family history record. (Strength=Required)FamilyHistoryStatus! »This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair"name : string [0..1]The 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 member history. (Strength=Example)FamilyMember?? »Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposesgender : code [0..1] « The gender of a person used for administrative purposes. (Strength=Required)AdministrativeGender! »The actual or approximate date of birth of the relativeborn[x] : Type [0..1] « Period|date|string »The actual or approximate age of the relative at the time the family member history is recordedage[x] : Type [0..1] « Quantity(Age)|Range|string »Deceased flag or the actual or approximate age of the relative at the time of death for the family member history recorddeceased[x] : Type [0..1] « boolean|Quantity(Age)|Range|date|string »This 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 : Annotation [0..1]ConditionThe 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 systemcode : CodeableConcept [1..1] « Identification of the Condition or diagnosis. (Strength=Example)Condition/Problem/Diagnosis ?? »Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. (Strength=Example)Condition Outcome ?? »Either 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] : Type [0..1] « Quantity(Age)|Range|Period|string »An area where general notes can be placed about this specific conditionnote : Annotation [0..1]The 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 conditioncondition[0..*]

XML Template

<FamilyMemberHistory 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 -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
 <gender value="[code]"/><!-- 0..1 male | female | other | unknown -->
 <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- ?? 0..1 Quantity(Age)|Range|string (approximate) age --></age[x]>
 <deceased[x]><!-- 0..1 boolean|Quantity(Age)|Range|date|string Dead? How old/when? --></deceased[x]>
 <note><!-- 0..1 Annotation General note about related person --></note>
 <condition>  <!-- 0..* Condition that the related person had -->
  <code><!-- 1..1 CodeableConcept Condition suffered by relation --></code>
  <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
  <onset[x]><!-- 0..1 Quantity(Age)|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..1 Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template

{doco
  "resourceType" : "FamilyMemberHistory",
  // 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
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "name" : "<string>", // The family member described
  "relationship" : { CodeableConcept }, // R!  Relationship to the subject
  "gender" : "<code>", // male | female | other | unknown
  // born[x]: (approximate) date of birth. One of these 3:
  "bornPeriod" : { Period },
  "bornDate" : "<date>",
  "bornString" : "<string>",
  // age[x]: (approximate) age. One of these 3:
  "ageQuantity" : { Quantity(Age) },
  "ageRange" : { Range },
  "ageString" : "<string>",
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedQuantity" : { Quantity(Age) },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "note" : { Annotation }, // General note about related person
  "condition" : [{ // Condition that the related person had
    "code" : { CodeableConcept }, // R!  Condition suffered by relation
    "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
    // onset[x]: When condition first manifested. One of these 4:
    "onsetQuantity" : { Quantity(Age) },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : { Annotation } // Extra information about condition
  }]
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyMemberHistory IDomainResourceInformation about patient's relatives, relevant for patient
Can have age[x] or born[x], but not both
... identifier 0..*IdentifierExternal Id(s) for this record
... patient Σ1..1Reference(Patient)Patient history is about
... date Σ0..1dateTimeWhen history was captured/updated
... status ?! Σ1..1codepartial | completed | entered-in-error | health-unknown
FamilyHistoryStatus (Required)
... name Σ0..1stringThe family member described
... relationship Σ1..1CodeableConceptRelationship to the subject
FamilyMember (Example)
... gender Σ0..1codemale | female | other | unknown
AdministrativeGender (Required)
... born[x] I0..1(approximate) date of birth
.... bornPeriodPeriod
.... bornDatedate
.... bornStringstring
... age[x] I0..1(approximate) age
.... ageQuantityAge
.... ageRangeRange
.... ageStringstring
... deceased[x] 0..1Dead? How old/when?
.... deceasedBooleanboolean
.... deceasedQuantityAge
.... deceasedRangeRange
.... deceasedDatedate
.... deceasedStringstring
... note 0..1AnnotationGeneral note about related person
... condition 0..*BackboneElementCondition that the related person had
.... code 1..1CodeableConceptCondition suffered by relation
Condition/Problem/Diagnosis Codes (Example)
.... outcome 0..1CodeableConceptdeceased | permanent disability | etc.
Condition Outcome Codes (Example)
.... onset[x] 0..1When condition first manifested
..... onsetQuantityAge
..... onsetRangeRange
..... onsetPeriodPeriod
..... onsetStringstring
.... note 0..1AnnotationExtra information about condition

doco Documentation for this format

UML Diagram

FamilyMemberHistory (DomainResource)This records identifiers associated with this family member 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 [1..1] « Patient »The date (and possibly time) when the family member history was takendate : dateTime [0..1]A code specifying a state of a Family Member History record (this element modifies the meaning of other elements)status : code [1..1] « A code that identifies the status of the family history record. (Strength=Required)FamilyHistoryStatus! »This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair"name : string [0..1]The 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 member history. (Strength=Example)FamilyMember?? »Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposesgender : code [0..1] « The gender of a person used for administrative purposes. (Strength=Required)AdministrativeGender! »The actual or approximate date of birth of the relativeborn[x] : Type [0..1] « Period|date|string »The actual or approximate age of the relative at the time the family member history is recordedage[x] : Type [0..1] « Quantity(Age)|Range|string »Deceased flag or the actual or approximate age of the relative at the time of death for the family member history recorddeceased[x] : Type [0..1] « boolean|Quantity(Age)|Range|date|string »This 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 : Annotation [0..1]ConditionThe 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 systemcode : CodeableConcept [1..1] « Identification of the Condition or diagnosis. (Strength=Example)Condition/Problem/Diagnosis ?? »Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. (Strength=Example)Condition Outcome ?? »Either 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] : Type [0..1] « Quantity(Age)|Range|Period|string »An area where general notes can be placed about this specific conditionnote : Annotation [0..1]The 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 conditioncondition[0..*]

XML Template

<FamilyMemberHistory 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 -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
 <gender value="[code]"/><!-- 0..1 male | female | other | unknown -->
 <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- ?? 0..1 Quantity(Age)|Range|string (approximate) age --></age[x]>
 <deceased[x]><!-- 0..1 boolean|Quantity(Age)|Range|date|string Dead? How old/when? --></deceased[x]>
 <note><!-- 0..1 Annotation General note about related person --></note>
 <condition>  <!-- 0..* Condition that the related person had -->
  <code><!-- 1..1 CodeableConcept Condition suffered by relation --></code>
  <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
  <onset[x]><!-- 0..1 Quantity(Age)|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..1 Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template

{doco
  "resourceType" : "FamilyMemberHistory",
  // 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
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "name" : "<string>", // The family member described
  "relationship" : { CodeableConcept }, // R!  Relationship to the subject
  "gender" : "<code>", // male | female | other | unknown
  // born[x]: (approximate) date of birth. One of these 3:
  "bornPeriod" : { Period },
  "bornDate" : "<date>",
  "bornString" : "<string>",
  // age[x]: (approximate) age. One of these 3:
  "ageQuantity" : { Quantity(Age) },
  "ageRange" : { Range },
  "ageString" : "<string>",
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedQuantity" : { Quantity(Age) },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "note" : { Annotation }, // General note about related person
  "condition" : [{ // Condition that the related person had
    "code" : { CodeableConcept }, // R!  Condition suffered by relation
    "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
    // onset[x]: When condition first manifested. One of these 4:
    "onsetQuantity" : { Quantity(Age) },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : { Annotation } // Extra information about condition
  }]
}

 

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

4.37.2.1 Terminology Bindings

PathDefinitionTypeReference
FamilyMemberHistory.status A code that identifies the status of the family history record.RequiredFamilyHistoryStatus
FamilyMemberHistory.relationship The nature of the relationship between the patient and the related person being described in the family member history.ExampleFamilyMember
FamilyMemberHistory.gender The gender of a person used for administrative purposes.RequiredAdministrativeGender
FamilyMemberHistory.condition.code Identification of the Condition or diagnosis.ExampleCondition/Problem/Diagnosis Codes
FamilyMemberHistory.condition.outcome The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.ExampleCondition Outcome Codes

4.37.2.2 Constraints

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

4.37.2.3 Processing information about the Femily Member History

The Family Member History List may contain other than FamilyMemberHistory resources. For example, a full Family History could be a List that might include a mixture of FamilyMemberHistory records as well as Observation records of things like "maternal family history of breast cancer".

4.37.3 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
codetokenA search by a condition codeFamilyMemberHistory.condition.code
datedateWhen history was captured/updatedFamilyMemberHistory.date
gendertokenA search by a gender code of a family memberFamilyMemberHistory.gender
identifiertokenA search by a record identifierFamilyMemberHistory.identifier
patientreferenceThe identity of a subject to list family member history items forFamilyMemberHistory.patient
(Patient)
relationshiptokenA search by a relationship typeFamilyMemberHistory.relationship