Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). 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 GroupMaturity Level: 2 Trial UseSecurity Category: Patient 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.

9.4.2 References to this Resource

9.4.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyMemberHistory TUDomainResourceInformation 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 Σ0..*IdentifierExternal Id(s) for this record

... instantiatesCanonical Σ0..*canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition)Instantiates FHIR protocol or definition

... instantiatesUri Σ0..*uriInstantiates external protocol or definition

... dataAbsentReason Σ0..1CodeableConceptsubject-unknown | withheld | unable-to-obtain | deferred
FamilyHistoryAbsentReason (Example)
... patient Σ1..1Reference(Patient)Patient history is about
... date Σ0..1dateTimeWhen history was recorded or last updated
... name Σ0..1stringThe family member described
... relationship Σ1..1CodeableConceptRelationship to the subject
FamilyMember (Example)
... sex Σ0..1CodeableConceptmale | female | other | unknown
AdministrativeGender (Extensible)
... born[x] C0..1(approximate) date of birth
.... bornPeriodPeriod
.... bornDatedate
.... bornStringstring
... age[x] ΣC0..1(approximate) age
.... ageAgeAge
.... ageRangeRange
.... ageStringstring
... estimatedAge ΣC0..1booleanAge is estimated?
... deceased[x] Σ0..1Dead? How old/when?
.... deceasedBooleanboolean
.... deceasedAgeAge
.... deceasedRangeRange
.... deceasedDatedate
.... deceasedStringstring
... reason Σ0..*CodeableReference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference)Why was family member history performed?
SNOMED CT Clinical Findings (Example)

... note 0..*AnnotationGeneral 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)
.... contributedToDeath 0..1booleanWhether the condition contributed to the cause of death
.... onset[x] 0..1When condition first manifested
..... onsetAgeAge
..... onsetRangeRange
..... onsetPeriodPeriod
..... onsetStringstring
.... note 0..*AnnotationExtra information about condition

... procedure 0..*BackboneElementProcedures that the related person had

.... code 1..1CodeableConceptProcedures performed on the related person
Procedure Codes (SNOMED CT) (Example)
.... outcome 0..1CodeableConceptWhat happened following the procedure
SNOMED CT Clinical Findings (Example)
.... contributedToDeath 0..1booleanWhether the procedure contributed to the cause of death
.... performed[x] 0..1When the procedure was performed
..... performedAgeAge
..... performedRangeRange
..... performedPeriodPeriod
..... performedStringstring
..... performedDateTimedateTime
.... note 0..*AnnotationExtra information about the procedure


doco Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

FamilyMemberHistory (DomainResource)Business identifiers assigned to this family member history by the performer or other systems which remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistoryinstantiatesCanonical : canonical [0..*] « PlanDefinition| Questionnaire|ActivityDefinition|Measure|OperationDefinition »The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistoryinstantiatesUri : uri [0..*]A code specifying the status of the record of the family history of a specific family member (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)FamilyHistoryStatus! »Describes why the family member's history is not availabledataAbsentReason : CodeableConcept [0..1] « null (Strength=Example) FamilyHistoryAbsentReason?? »The person who this history concernspatient : Reference [1..1] « Patient »The date (and possibly time) when the family member history was recorded or last updateddate : dateTime [0..1]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] « null (Strength=Example)FamilyMember?? »The birth sex of the family membersex : CodeableConcept [0..1] « null (Strength=Extensible)AdministrativeGender+ »The actual or approximate date of birth of the relativeborn[x] : DataType [0..1] « Period|date|string » « This element has or is affected by some invariantsC »The age of the relative at the time the family member history is recordedage[x] : DataType [0..1] « Age|Range|string » « This element has or is affected by some invariantsC »If true, indicates that the age value specified is an estimated valueestimatedAge : boolean [0..1] « This element has or is affected by some invariantsC »Deceased flag or the actual or approximate age of the relative at the time of death for the family member history recorddeceased[x] : DataType [0..1] « boolean|Age|Range|date|string »Describes why the family member history occurred in coded or textual form, or Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history eventreason : CodeableReference [0..*] « Condition|Observation| AllergyIntolerance|QuestionnaireResponse|DiagnosticReport| DocumentReference; null (Strength=Example)SNOMEDCTClinicalFindings?? »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..*]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] « null (Strength=Example)Condition/Problem/DiagnosisCo...?? »Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « null (Strength=Example)ConditionOutcomeCodes?? »This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknowncontributedToDeath : boolean [0..1]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] : DataType [0..1] « Age|Range|Period|string »An area where general notes can be placed about this specific conditionnote : Annotation [0..*]ProcedureThe actual procedure specified. Could be a coded procedure or a less specific string depending on how much is known about the procedure and the capabilities of the creating systemcode : CodeableConcept [1..1] « null (Strength=Example)ProcedureCodes(SNOMEDCT)?? »Indicates what happened following the procedure. If the procedure resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTClinicalFindings?? »This procedure contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknowncontributedToDeath : boolean [0..1]Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be capturedperformed[x] : DataType [0..1] « Age|Range|Period|string|dateTime »An area where general notes can be placed about this specific procedurenote : Annotation [0..*]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..*]The significant Procedures (or procedure) that the family member had. This is a repeating section to allow a system to represent more than one procedure per resource, though there is nothing stopping multiple resources - one per procedureprocedure[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>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) 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>
 <sex><!-- 0..1 CodeableConcept male | female | other | unknown --></sex>
 <born[x]><!-- I 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- I 0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!-- I 0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reason><!-- 0..* CodeableReference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) Why was family member history performed? --></reason>
 <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>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the condition contributed to the cause of death -->
  <onset[x]><!-- 0..1 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
 <procedure>  <!-- 0..* Procedures that the related person had -->
  <code><!-- 1..1 CodeableConcept Procedures performed on the related person --></code>
  <outcome><!-- 0..1 CodeableConcept What happened following the procedure --></outcome>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the procedure contributed to the cause of death -->
  <performed[x]><!-- 0..1 Age|Range|Period|string|dateTime When the procedure was performed --></performed[x]>
  <note><!-- 0..* Annotation Extra information about the procedure --></note>
 </procedure>
</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
  "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 
  "sex" : { CodeableConcept }, // 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:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // I Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reason" : [{ CodeableReference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) }], // 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.
    "contributedToDeath" : <boolean>, // Whether the condition contributed to the cause of death
    // onset[x]: When condition first manifested. One of these 4:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }],
  "procedure" : [{ // Procedures that the related person had
    "code" : { CodeableConcept }, // R!  Procedures performed on the related person
    "outcome" : { CodeableConcept }, // What happened following the procedure
    "contributedToDeath" : <boolean>, // Whether the procedure contributed to the cause of death
    // performed[x]: When the procedure was performed. One of these 5:
    "performedAge" : { Age },
    "performedRange" : { Range },
    "performedPeriod" : { Period },
    "performedString" : "<string>",
    "performedDateTime" : "<dateTime>",
    "note" : [{ Annotation }] // Extra information about the procedure
  }]
}

Turtle Template

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


[ 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(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ], ... ; # 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.sex [ CodeableConcept ]; # 0..1 male | female | other | unknown
  # FamilyMemberHistory.born[x] : 0..1 I (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 I (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 I 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.reason [ CodeableReference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ], ... ; # 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.
    fhir:FamilyMemberHistory.condition.contributedToDeath [ boolean ]; # 0..1 Whether the condition contributed to the cause of death
    # 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
  ], ...;
  fhir:FamilyMemberHistory.procedure [ # 0..* Procedures that the related person had
    fhir:FamilyMemberHistory.procedure.code [ CodeableConcept ]; # 1..1 Procedures performed on the related person
    fhir:FamilyMemberHistory.procedure.outcome [ CodeableConcept ]; # 0..1 What happened following the procedure
    fhir:FamilyMemberHistory.procedure.contributedToDeath [ boolean ]; # 0..1 Whether the procedure contributed to the cause of death
    # FamilyMemberHistory.procedure.performed[x] : 0..1 When the procedure was performed. One of these 5
      fhir:FamilyMemberHistory.procedure.performedAge [ Age ]
      fhir:FamilyMemberHistory.procedure.performedRange [ Range ]
      fhir:FamilyMemberHistory.procedure.performedPeriod [ Period ]
      fhir:FamilyMemberHistory.procedure.performedString [ string ]
      fhir:FamilyMemberHistory.procedure.performedDateTime [ dateTime ]
    fhir:FamilyMemberHistory.procedure.note [ Annotation ], ... ; # 0..* Extra information about the procedure
  ], ...;
]

Changes since R4

FamilyMemberHistory
FamilyMemberHistory.sex
  • Change value set from http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/administrative-gender
  • Change value set from http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/administrative-gender
FamilyMemberHistory.reason
  • Added Element
FamilyMemberHistory.procedure
  • Added Element
FamilyMemberHistory.procedure.code
  • Added Mandatory Element
FamilyMemberHistory.procedure.outcome
  • Added Element
FamilyMemberHistory.procedure.contributedToDeath
  • Added Element
FamilyMemberHistory.procedure.performed[x]
  • Added Element
FamilyMemberHistory.procedure.note
  • Added Element
FamilyMemberHistory.reasonCode
  • deleted
FamilyMemberHistory.reasonReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors).)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. FamilyMemberHistory TUDomainResourceInformation 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 Σ0..*IdentifierExternal Id(s) for this record

... instantiatesCanonical Σ0..*canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition)Instantiates FHIR protocol or definition

... instantiatesUri Σ0..*uriInstantiates external protocol or definition

... dataAbsentReason Σ0..1CodeableConceptsubject-unknown | withheld | unable-to-obtain | deferred
FamilyHistoryAbsentReason (Example)
... patient Σ1..1Reference(Patient)Patient history is about
... date Σ0..1dateTimeWhen history was recorded or last updated
... name Σ0..1stringThe family member described
... relationship Σ1..1CodeableConceptRelationship to the subject
FamilyMember (Example)
... sex Σ0..1CodeableConceptmale | female | other | unknown
AdministrativeGender (Extensible)
... born[x] C0..1(approximate) date of birth
.... bornPeriodPeriod
.... bornDatedate
.... bornStringstring
... age[x] ΣC0..1(approximate) age
.... ageAgeAge
.... ageRangeRange
.... ageStringstring
... estimatedAge ΣC0..1booleanAge is estimated?
... deceased[x] Σ0..1Dead? How old/when?
.... deceasedBooleanboolean
.... deceasedAgeAge
.... deceasedRangeRange
.... deceasedDatedate
.... deceasedStringstring
... reason Σ0..*CodeableReference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference)Why was family member history performed?
SNOMED CT Clinical Findings (Example)

... note 0..*AnnotationGeneral 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)
.... contributedToDeath 0..1booleanWhether the condition contributed to the cause of death
.... onset[x] 0..1When condition first manifested
..... onsetAgeAge
..... onsetRangeRange
..... onsetPeriodPeriod
..... onsetStringstring
.... note 0..*AnnotationExtra information about condition

... procedure 0..*BackboneElementProcedures that the related person had

.... code 1..1CodeableConceptProcedures performed on the related person
Procedure Codes (SNOMED CT) (Example)
.... outcome 0..1CodeableConceptWhat happened following the procedure
SNOMED CT Clinical Findings (Example)
.... contributedToDeath 0..1booleanWhether the procedure contributed to the cause of death
.... performed[x] 0..1When the procedure was performed
..... performedAgeAge
..... performedRangeRange
..... performedPeriodPeriod
..... performedStringstring
..... performedDateTimedateTime
.... note 0..*AnnotationExtra information about the procedure


doco Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

FamilyMemberHistory (DomainResource)Business identifiers assigned to this family member history by the performer or other systems which remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistoryinstantiatesCanonical : canonical [0..*] « PlanDefinition| Questionnaire|ActivityDefinition|Measure|OperationDefinition »The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistoryinstantiatesUri : uri [0..*]A code specifying the status of the record of the family history of a specific family member (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)FamilyHistoryStatus! »Describes why the family member's history is not availabledataAbsentReason : CodeableConcept [0..1] « null (Strength=Example) FamilyHistoryAbsentReason?? »The person who this history concernspatient : Reference [1..1] « Patient »The date (and possibly time) when the family member history was recorded or last updateddate : dateTime [0..1]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] « null (Strength=Example)FamilyMember?? »The birth sex of the family membersex : CodeableConcept [0..1] « null (Strength=Extensible)AdministrativeGender+ »The actual or approximate date of birth of the relativeborn[x] : DataType [0..1] « Period|date|string » « This element has or is affected by some invariantsC »The age of the relative at the time the family member history is recordedage[x] : DataType [0..1] « Age|Range|string » « This element has or is affected by some invariantsC »If true, indicates that the age value specified is an estimated valueestimatedAge : boolean [0..1] « This element has or is affected by some invariantsC »Deceased flag or the actual or approximate age of the relative at the time of death for the family member history recorddeceased[x] : DataType [0..1] « boolean|Age|Range|date|string »Describes why the family member history occurred in coded or textual form, or Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history eventreason : CodeableReference [0..*] « Condition|Observation| AllergyIntolerance|QuestionnaireResponse|DiagnosticReport| DocumentReference; null (Strength=Example)SNOMEDCTClinicalFindings?? »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..*]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] « null (Strength=Example)Condition/Problem/DiagnosisCo...?? »Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « null (Strength=Example)ConditionOutcomeCodes?? »This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknowncontributedToDeath : boolean [0..1]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] : DataType [0..1] « Age|Range|Period|string »An area where general notes can be placed about this specific conditionnote : Annotation [0..*]ProcedureThe actual procedure specified. Could be a coded procedure or a less specific string depending on how much is known about the procedure and the capabilities of the creating systemcode : CodeableConcept [1..1] « null (Strength=Example)ProcedureCodes(SNOMEDCT)?? »Indicates what happened following the procedure. If the procedure resulted in death, deceased date is captured on the relationoutcome : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTClinicalFindings?? »This procedure contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknowncontributedToDeath : boolean [0..1]Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be capturedperformed[x] : DataType [0..1] « Age|Range|Period|string|dateTime »An area where general notes can be placed about this specific procedurenote : Annotation [0..*]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..*]The significant Procedures (or procedure) that the family member had. This is a repeating section to allow a system to represent more than one procedure per resource, though there is nothing stopping multiple resources - one per procedureprocedure[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>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) 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>
 <sex><!-- 0..1 CodeableConcept male | female | other | unknown --></sex>
 <born[x]><!-- I 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- I 0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!-- I 0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reason><!-- 0..* CodeableReference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) Why was family member history performed? --></reason>
 <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>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the condition contributed to the cause of death -->
  <onset[x]><!-- 0..1 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
 <procedure>  <!-- 0..* Procedures that the related person had -->
  <code><!-- 1..1 CodeableConcept Procedures performed on the related person --></code>
  <outcome><!-- 0..1 CodeableConcept What happened following the procedure --></outcome>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the procedure contributed to the cause of death -->
  <performed[x]><!-- 0..1 Age|Range|Period|string|dateTime When the procedure was performed --></performed[x]>
  <note><!-- 0..* Annotation Extra information about the procedure --></note>
 </procedure>
</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
  "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 
  "sex" : { CodeableConcept }, // 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:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // I Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reason" : [{ CodeableReference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) }], // 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.
    "contributedToDeath" : <boolean>, // Whether the condition contributed to the cause of death
    // onset[x]: When condition first manifested. One of these 4:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }],
  "procedure" : [{ // Procedures that the related person had
    "code" : { CodeableConcept }, // R!  Procedures performed on the related person
    "outcome" : { CodeableConcept }, // What happened following the procedure
    "contributedToDeath" : <boolean>, // Whether the procedure contributed to the cause of death
    // performed[x]: When the procedure was performed. One of these 5:
    "performedAge" : { Age },
    "performedRange" : { Range },
    "performedPeriod" : { Period },
    "performedString" : "<string>",
    "performedDateTime" : "<dateTime>",
    "note" : [{ Annotation }] // Extra information about the procedure
  }]
}

Turtle Template

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


[ 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(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ], ... ; # 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.sex [ CodeableConcept ]; # 0..1 male | female | other | unknown
  # FamilyMemberHistory.born[x] : 0..1 I (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 I (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 I 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.reason [ CodeableReference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ], ... ; # 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.
    fhir:FamilyMemberHistory.condition.contributedToDeath [ boolean ]; # 0..1 Whether the condition contributed to the cause of death
    # 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
  ], ...;
  fhir:FamilyMemberHistory.procedure [ # 0..* Procedures that the related person had
    fhir:FamilyMemberHistory.procedure.code [ CodeableConcept ]; # 1..1 Procedures performed on the related person
    fhir:FamilyMemberHistory.procedure.outcome [ CodeableConcept ]; # 0..1 What happened following the procedure
    fhir:FamilyMemberHistory.procedure.contributedToDeath [ boolean ]; # 0..1 Whether the procedure contributed to the cause of death
    # FamilyMemberHistory.procedure.performed[x] : 0..1 When the procedure was performed. One of these 5
      fhir:FamilyMemberHistory.procedure.performedAge [ Age ]
      fhir:FamilyMemberHistory.procedure.performedRange [ Range ]
      fhir:FamilyMemberHistory.procedure.performedPeriod [ Period ]
      fhir:FamilyMemberHistory.procedure.performedString [ string ]
      fhir:FamilyMemberHistory.procedure.performedDateTime [ dateTime ]
    fhir:FamilyMemberHistory.procedure.note [ Annotation ], ... ; # 0..* Extra information about the procedure
  ], ...;
]

Changes since Release 4

FamilyMemberHistory
FamilyMemberHistory.sex
  • Change value set from http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/administrative-gender
  • Change value set from http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/administrative-gender
FamilyMemberHistory.reason
  • Added Element
FamilyMemberHistory.procedure
  • Added Element
FamilyMemberHistory.procedure.code
  • Added Mandatory Element
FamilyMemberHistory.procedure.outcome
  • Added Element
FamilyMemberHistory.procedure.contributedToDeath
  • Added Element
FamilyMemberHistory.procedure.performed[x]
  • Added Element
FamilyMemberHistory.procedure.note
  • Added Element
FamilyMemberHistory.reasonCode
  • deleted
FamilyMemberHistory.reasonReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors).)

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

9.4.3.1 Terminology Bindings

PathDefinitionTypeReference
FamilyMemberHistory.status

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

RequiredFamilyHistoryStatus
FamilyMemberHistory.dataAbsentReason

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

ExampleFamilyHistoryAbsentReason
FamilyMemberHistory.relationship

A relationship between two people characterizing their "familial" relationship

ExampleFamilyMember
FamilyMemberHistory.sex

The gender of a person used for administrative purposes.

ExtensibleAdministrativeGender
FamilyMemberHistory.reason

This value set includes all the "Clinical finding" SNOMED CT codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

ExampleSNOMEDCTClinicalFindings
FamilyMemberHistory.condition.code

Example value set for Condition/Problem/Diagnosis codes.

ExampleCondition/Problem/DiagnosisCodes
FamilyMemberHistory.condition.outcome

Example value set for condition outcomes.

ExampleConditionOutcomeCodes
FamilyMemberHistory.procedure.code

Procedure Code: All SNOMED CT procedure codes.

ExampleProcedureCodes(SNOMEDCT)
FamilyMemberHistory.procedure.outcome

This value set includes all the "Clinical finding" SNOMED CT codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

ExampleSNOMEDCTClinicalFindings

9.4.3.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
 fhs-1Rule (base)Can have age[x] or born[x], but not bothage.empty() or born.empty()
 fhs-2Rule (base)Can only have estimatedAge if age[x] is presentage.exists() or estimatedAge.empty()

9.4.3.3 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.

9.4.3.4 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, No Information Available 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.

9.4.4 Search Parameters

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

NameTypeDescriptionExpressionIn Common
codetokenA search by a condition codeFamilyMemberHistory.condition.code
date NdateWhen history was recorded or last updatedFamilyMemberHistory.date
identifiertokenA search by a record identifierFamilyMemberHistory.identifier
instantiates-canonical NreferenceInstantiates FHIR protocol or definitionFamilyMemberHistory.instantiatesCanonical
(Questionnaire, Measure, PlanDefinition, OperationDefinition, ActivityDefinition)
instantiates-uri NuriInstantiates external protocol or definitionFamilyMemberHistory.instantiatesUri
patientreferenceThe identity of a subject to list family member history items forFamilyMemberHistory.patient
(Patient)
relationshiptokenA search by a relationship typeFamilyMemberHistory.relationship
sextokenA search by a sex code of a family memberFamilyMemberHistory.sex
status Ntokenpartial | completed | entered-in-error | health-unknownFamilyMemberHistory.status