This page is part of the FHIR Specification (v3.5.0: R4 Ballot #2). 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

9.4 Resource FamilyMemberHistory - Content

Patient Care

Work Group

Maturity Level: 2

Trial Use

Compartments: Patient

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

9.4.1 Scope and Usage

FamilyMemberHistory is one of the event resources in the FHIR workflow specification.

This resource records significant health 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 AdverseEvent and ClinicalImpression

Structure

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	I TU		DomainResource	Information about patient's relatives, relevant for patient + Rule: Can have age[x] or born[x], but not both + Rule: Can only have estimatedAge if age[x] is present Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| Questionnaire \| ActivityDefinition \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial \| completed \| entered-in-error \| health-unknown FamilyHistoryStatus (Required)
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown \| withheld \| unable-to-obtain \| deferred FamilyHistoryAbsentReason (Example)
patient	Σ	1..1	Reference(Patient)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
name	Σ	0..1	string	The family member described
relationship	Σ	1..1	CodeableConcept	Relationship to the subject V3 Value SetFamilyMember (Example)
gender	Σ	0..1	CodeableConcept	male \| female \| unknown Birth Sex (Extensible)
born[x]	I	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	Σ I	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	Σ I	0..1	boolean	Age is estimated?
deceased[x]	Σ	0..1		Dead? How old/when?
deceasedBoolean			boolean
deceasedAge			Age
deceasedRange			Range
deceasedDate			date
deceasedString			string
reasonCode	Σ	0..*	CodeableConcept	Why was family member history performed? SNOMED CT Clinical Findings (Example)
reasonReference	Σ	0..*	Reference(Condition \| Observation \| AllergyIntolerance \| QuestionnaireResponse \| DiagnosticReport \| DocumentReference)	Why was family member history performed?
note		0..*	Annotation	General note about related person
condition		0..*	BackboneElement	Condition that the related person had
code		1..1	CodeableConcept	Condition suffered by relation Condition/Problem/Diagnosis Codes (Example)
outcome		0..1	CodeableConcept	deceased \| permanent disability \| etc. Condition Outcome Codes (Example)
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
Documentation for this format

UML Diagram (Legend)

XML Template

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(PlanDefinition|Questionnaire|
   ActivityDefinition|Measure|OperationDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <dataAbsentReason><!-- 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred --></dataAbsentReason>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was recorded or last updated -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
 <gender><!-- 0..1 CodeableConcept male | female | unknown --></gender>
 <born[x]><!--  0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!--  0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!--  0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reasonCode><!-- 0..* CodeableConcept Why was family member history performed? --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|AllergyIntolerance|
   QuestionnaireResponse|DiagnosticReport|DocumentReference) Why was family member history performed? --></reasonReference>
 <note><!-- 0..* 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 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template

{
  "resourceType" : "FamilyMemberHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "instantiatesCanonical" : [{ canonical(PlanDefinition|Questionnaire|
   ActivityDefinition|Measure|OperationDefinition) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "dataAbsentReason" : { CodeableConcept }, // subject-unknown | withheld | unable-to-obtain | deferred
  "patient" : { Reference(Patient) }, // R!  Patient history is about
  "date" : "<dateTime>", // When history was recorded or last updated
  "name" : "<string>", // The family member described
  "relationship" : { CodeableConcept }, // R!  Relationship to the subject
  "gender" : { CodeableConcept }, // male | female | 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:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // C? Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reasonCode" : [{ CodeableConcept }], // Why was family member history performed?
  "reasonReference" : [{ Reference(Condition|Observation|AllergyIntolerance|
   QuestionnaireResponse|DiagnosticReport|DocumentReference) }], // Why was family member history performed?
  "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:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:FamilyMemberHistory;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:FamilyMemberHistory.identifier [ Identifier ], ... ; # 0..* External Id(s) for this record
  fhir:FamilyMemberHistory.instantiatesCanonical [ canonical(PlanDefinition|Questionnaire|ActivityDefinition|Measure|OperationDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:FamilyMemberHistory.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:FamilyMemberHistory.status [ code ]; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:FamilyMemberHistory.dataAbsentReason [ CodeableConcept ]; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:FamilyMemberHistory.patient [ Reference(Patient) ]; # 1..1 Patient history is about
  fhir:FamilyMemberHistory.date [ dateTime ]; # 0..1 When history was recorded or last updated
  fhir:FamilyMemberHistory.name [ string ]; # 0..1 The family member described
  fhir:FamilyMemberHistory.relationship [ CodeableConcept ]; # 1..1 Relationship to the subject
  fhir:FamilyMemberHistory.gender [ CodeableConcept ]; # 0..1 male | female | unknown
  # FamilyMemberHistory.born[x] : 0..1 (approximate) date of birth. One of these 3
    fhir:FamilyMemberHistory.bornPeriod [ Period ]
    fhir:FamilyMemberHistory.bornDate [ date ]
    fhir:FamilyMemberHistory.bornString [ string ]
  # FamilyMemberHistory.age[x] : 0..1 (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 Age is estimated?
  # FamilyMemberHistory.deceased[x] : 0..1 Dead? How old/when?. One of these 5
    fhir:FamilyMemberHistory.deceasedBoolean [ boolean ]
    fhir:FamilyMemberHistory.deceasedAge [ Age ]
    fhir:FamilyMemberHistory.deceasedRange [ Range ]
    fhir:FamilyMemberHistory.deceasedDate [ date ]
    fhir:FamilyMemberHistory.deceasedString [ string ]
  fhir:FamilyMemberHistory.reasonCode [ CodeableConcept ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.reasonReference [ Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse|DiagnosticReport|
  DocumentReference) ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.note [ Annotation ], ... ; # 0..* General note about related person
  fhir:FamilyMemberHistory.condition [ # 0..* Condition that the related person had
    fhir:FamilyMemberHistory.condition.code [ CodeableConcept ]; # 1..1 Condition suffered by relation
    fhir:FamilyMemberHistory.condition.outcome [ CodeableConcept ]; # 0..1 deceased | permanent disability | etc.
    # FamilyMemberHistory.condition.onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:FamilyMemberHistory.condition.onsetAge [ Age ]
      fhir:FamilyMemberHistory.condition.onsetRange [ Range ]
      fhir:FamilyMemberHistory.condition.onsetPeriod [ Period ]
      fhir:FamilyMemberHistory.condition.onsetString [ string ]
    fhir:FamilyMemberHistory.condition.note [ Annotation ], ... ; # 0..* Extra information about condition
  ], ...;
]

Changes since R3

FamilyMemberHistory

FamilyMemberHistory.instantiatesCanonical

Added Element

FamilyMemberHistory.instantiatesUri

Added Element

FamilyMemberHistory.dataAbsentReason

Added Element

FamilyMemberHistory.gender

Type changed from code to CodeableConcept
Change binding strength from required to extensible
Change value set from http://hl7.org/fhir/ValueSet/administrative-gender to http://hl7.org/fhir/ValueSet/birth-sex

FamilyMemberHistory.estimatedAge

No longer marked as Modifier

FamilyMemberHistory.reasonReference

Type changed from Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse) to Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse|DiagnosticReport|DocumentReference)

FamilyMemberHistory.definition

deleted

FamilyMemberHistory.notDone

deleted

FamilyMemberHistory.notDoneReason

deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests of which 2 fail to execute.)

Structure

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	I TU		DomainResource	Information about patient's relatives, relevant for patient + Rule: Can have age[x] or born[x], but not both + Rule: Can only have estimatedAge if age[x] is present Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| Questionnaire \| ActivityDefinition \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial \| completed \| entered-in-error \| health-unknown FamilyHistoryStatus (Required)
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown \| withheld \| unable-to-obtain \| deferred FamilyHistoryAbsentReason (Example)
patient	Σ	1..1	Reference(Patient)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
name	Σ	0..1	string	The family member described
relationship	Σ	1..1	CodeableConcept	Relationship to the subject V3 Value SetFamilyMember (Example)
gender	Σ	0..1	CodeableConcept	male \| female \| unknown Birth Sex (Extensible)
born[x]	I	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	Σ I	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	Σ I	0..1	boolean	Age is estimated?
deceased[x]	Σ	0..1		Dead? How old/when?
deceasedBoolean			boolean
deceasedAge			Age
deceasedRange			Range
deceasedDate			date
deceasedString			string
reasonCode	Σ	0..*	CodeableConcept	Why was family member history performed? SNOMED CT Clinical Findings (Example)
reasonReference	Σ	0..*	Reference(Condition \| Observation \| AllergyIntolerance \| QuestionnaireResponse \| DiagnosticReport \| DocumentReference)	Why was family member history performed?
note		0..*	Annotation	General note about related person
condition		0..*	BackboneElement	Condition that the related person had
code		1..1	CodeableConcept	Condition suffered by relation Condition/Problem/Diagnosis Codes (Example)
outcome		0..1	CodeableConcept	deceased \| permanent disability \| etc. Condition Outcome Codes (Example)
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
Documentation for this format

UML Diagram (Legend)

XML Template

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(PlanDefinition|Questionnaire|
   ActivityDefinition|Measure|OperationDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <dataAbsentReason><!-- 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred --></dataAbsentReason>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was recorded or last updated -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <relationship><!-- 1..1 CodeableConcept Relationship to the subject --></relationship>
 <gender><!-- 0..1 CodeableConcept male | female | unknown --></gender>
 <born[x]><!--  0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!--  0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!--  0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reasonCode><!-- 0..* CodeableConcept Why was family member history performed? --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|AllergyIntolerance|
   QuestionnaireResponse|DiagnosticReport|DocumentReference) Why was family member history performed? --></reasonReference>
 <note><!-- 0..* 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 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template

{
  "resourceType" : "FamilyMemberHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "instantiatesCanonical" : [{ canonical(PlanDefinition|Questionnaire|
   ActivityDefinition|Measure|OperationDefinition) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "dataAbsentReason" : { CodeableConcept }, // subject-unknown | withheld | unable-to-obtain | deferred
  "patient" : { Reference(Patient) }, // R!  Patient history is about
  "date" : "<dateTime>", // When history was recorded or last updated
  "name" : "<string>", // The family member described
  "relationship" : { CodeableConcept }, // R!  Relationship to the subject
  "gender" : { CodeableConcept }, // male | female | 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:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // C? Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reasonCode" : [{ CodeableConcept }], // Why was family member history performed?
  "reasonReference" : [{ Reference(Condition|Observation|AllergyIntolerance|
   QuestionnaireResponse|DiagnosticReport|DocumentReference) }], // Why was family member history performed?
  "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:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:FamilyMemberHistory;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:FamilyMemberHistory.identifier [ Identifier ], ... ; # 0..* External Id(s) for this record
  fhir:FamilyMemberHistory.instantiatesCanonical [ canonical(PlanDefinition|Questionnaire|ActivityDefinition|Measure|OperationDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:FamilyMemberHistory.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:FamilyMemberHistory.status [ code ]; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:FamilyMemberHistory.dataAbsentReason [ CodeableConcept ]; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:FamilyMemberHistory.patient [ Reference(Patient) ]; # 1..1 Patient history is about
  fhir:FamilyMemberHistory.date [ dateTime ]; # 0..1 When history was recorded or last updated
  fhir:FamilyMemberHistory.name [ string ]; # 0..1 The family member described
  fhir:FamilyMemberHistory.relationship [ CodeableConcept ]; # 1..1 Relationship to the subject
  fhir:FamilyMemberHistory.gender [ CodeableConcept ]; # 0..1 male | female | unknown
  # FamilyMemberHistory.born[x] : 0..1 (approximate) date of birth. One of these 3
    fhir:FamilyMemberHistory.bornPeriod [ Period ]
    fhir:FamilyMemberHistory.bornDate [ date ]
    fhir:FamilyMemberHistory.bornString [ string ]
  # FamilyMemberHistory.age[x] : 0..1 (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 Age is estimated?
  # FamilyMemberHistory.deceased[x] : 0..1 Dead? How old/when?. One of these 5
    fhir:FamilyMemberHistory.deceasedBoolean [ boolean ]
    fhir:FamilyMemberHistory.deceasedAge [ Age ]
    fhir:FamilyMemberHistory.deceasedRange [ Range ]
    fhir:FamilyMemberHistory.deceasedDate [ date ]
    fhir:FamilyMemberHistory.deceasedString [ string ]
  fhir:FamilyMemberHistory.reasonCode [ CodeableConcept ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.reasonReference [ Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse|DiagnosticReport|
  DocumentReference) ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.note [ Annotation ], ... ; # 0..* General note about related person
  fhir:FamilyMemberHistory.condition [ # 0..* Condition that the related person had
    fhir:FamilyMemberHistory.condition.code [ CodeableConcept ]; # 1..1 Condition suffered by relation
    fhir:FamilyMemberHistory.condition.outcome [ CodeableConcept ]; # 0..1 deceased | permanent disability | etc.
    # FamilyMemberHistory.condition.onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:FamilyMemberHistory.condition.onsetAge [ Age ]
      fhir:FamilyMemberHistory.condition.onsetRange [ Range ]
      fhir:FamilyMemberHistory.condition.onsetPeriod [ Period ]
      fhir:FamilyMemberHistory.condition.onsetString [ string ]
    fhir:FamilyMemberHistory.condition.note [ Annotation ], ... ; # 0..* Extra information about condition
  ], ...;
]

Changes since Release 3

FamilyMemberHistory

FamilyMemberHistory.instantiatesCanonical

Added Element

FamilyMemberHistory.instantiatesUri

Added Element

FamilyMemberHistory.dataAbsentReason

Added Element

FamilyMemberHistory.gender

Type changed from code to CodeableConcept
Change binding strength from required to extensible
Change value set from http://hl7.org/fhir/ValueSet/administrative-gender to http://hl7.org/fhir/ValueSet/birth-sex

FamilyMemberHistory.estimatedAge

No longer marked as Modifier

FamilyMemberHistory.reasonReference

Type changed from Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse) to Reference(Condition|Observation|AllergyIntolerance|QuestionnaireResponse|DiagnosticReport|DocumentReference)

FamilyMemberHistory.definition

deleted

FamilyMemberHistory.notDone

deleted

FamilyMemberHistory.notDoneReason

deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests of which 2 fail to execute.)

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

9.4.2.1 Terminology Bindings

Path	Definition	Type	Reference
FamilyMemberHistory.status	A code that identifies the status of the family history record.	Required	FamilyHistoryStatus
FamilyMemberHistory.dataAbsentReason	Codes describing the reason why a family member's history is not available.	Example	FamilyHistoryAbsentReason
FamilyMemberHistory.relationship	The nature of the relationship between the patient and the related person being described in the family member history.	Example	v3.FamilyMember
FamilyMemberHistory.gender	Codes describing the sex assigned at birth as documented on the birth registration.	Extensible	BirthSex
FamilyMemberHistory.reasonCode	Codes indicating why the family member history was done.	Example	SNOMEDCTClinicalFindings
FamilyMemberHistory.condition.code	Identification of the Condition or diagnosis.	Example	Condition/Problem/DiagnosisCodes
FamilyMemberHistory.condition.outcome	The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.	Example	ConditionOutcomeCodes

Path

Definition

Type

Reference

FamilyMemberHistory.status

A code that identifies the status of the family history record.

Required

FamilyHistoryStatus

FamilyMemberHistory.dataAbsentReason

Codes describing the reason why a family member's history is not available.

Example

FamilyHistoryAbsentReason

FamilyMemberHistory.relationship

The nature of the relationship between the patient and the related person being described in the family member history.

Example

v3.FamilyMember

FamilyMemberHistory.gender

Codes describing the sex assigned at birth as documented on the birth registration.

Extensible

BirthSex

FamilyMemberHistory.reasonCode

Codes indicating why the family member history was done.

Example

SNOMEDCTClinicalFindings

FamilyMemberHistory.condition.code

Identification of the Condition or diagnosis.

Example

Condition/Problem/DiagnosisCodes

FamilyMemberHistory.condition.outcome

The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.

Example

ConditionOutcomeCodes

9.4.2.2 Constraints

Level

Location

Description

Expression

fhs-1

Rule

(base)

Can have age[x] or born[x], but not both

age.empty() or born.empty()

fhs-2

Rule

(base)

Can only have estimatedAge if age[x] is present

age.exists() or estimatedAge.empty()

9.4.2.3 Processing information about the Family 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", "number of siblings", "number of female family members with breast cancer" etc.

The List representing a patient's "family history" can include Condition and Observation records that capture "family-history" relevant assertions about the patient themselves that would typically be captured as part of a family history.

9.4.2.4 No Known Patient History, No Known Problems, and Negated Conditions

Not Reviewed, Not Asked

When a sending system does not have family history about any family members or the statement is about family history not yet being asked, then the List resource should be used to indicate the List.emptyReason="notasked".

Reviewed, None Identified for Family

After reasonable investigation that there are no known items for the family member history list, then the List resource should be used to indicate the List.emptyReason="nilknown". The List.emptyReason represents a statement about the full scope of the list (i.e. the patient or patient's agent/guardian has asserted that there are no conditions or significant events for any family members to record).

Reviewed, None Identified for a Family Member

When an individual family member's history is not available, FamilyMemberHistory.dataAbsentReason can be used to indicate why that family member's history is not available (e.g. subject unknown).

Reviewed, No Known Problems or Negated Condition for a Family Member

The FamilyMemberHistory.condition.code can be used to capture "No Known Problems" or negated conditions, such as "No history of malignant tumor of breast", for an individual family member.

9.4.3 Search Parameters

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

Name	Type	Description	Expression	In Common
code	token	A search by a condition code	FamilyMemberHistory.condition.code	13 Resources
date	date	When history was recorded or last updated	FamilyMemberHistory.date	17 Resources
gender	token	A search by a gender code of a family member	FamilyMemberHistory.gender
identifier	token	A search by a record identifier	FamilyMemberHistory.identifier	30 Resources
instantiates-canonical	reference	Instantiates FHIR protocol or definition	FamilyMemberHistory.instantiatesCanonical (Questionnaire, Measure, PlanDefinition, OperationDefinition, ActivityDefinition)
instantiates-uri	uri	Instantiates external protocol or definition	FamilyMemberHistory.instantiatesUri
patient	reference	The identity of a subject to list family member history items for	FamilyMemberHistory.patient.where(resolve() is Patient) (Patient)	29 Resources
relationship	token	A search by a relationship type	FamilyMemberHistory.relationship
status	token	partial \| completed \| entered-in-error \| health-unknown	FamilyMemberHistory.status