Profile qicore-familymemberhistory

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="qicore-familymemberhistory"/>
  <url
       value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-familymemberhistory"/>
  <name value="Profile qicore-familymemberhistory"/>
  <status value="draft"/>
  <publisher
             value="Health Level Seven International (Clinical Quality Information - QICore)"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <date value="2015-02-27"/>
  <mapping>
    <identity value="qdm"/>
    <uri value="http://www.healthit.gov/quality-data-model"/>
    <name value="Quality Data Model"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="FamilyMemberHistory"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="FamilyMemberHistory:qicore-familymemberhistory">
      <path value="FamilyMemberHistory"/>
      <name value="QICore-FamilyMemberHistory"/>
      <short
             value="Information about patient's relatives, relevant for patient"/>
      <definition
                  value="Significant health events and conditions for a person related to the patient relevant in the context of care for the patient."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="FamilyMemberHistory"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))"/>
      </constraint>
      <constraint>
        <key value="fhs-2"/>
        <severity value="error"/>
        <human value="Can only have estimatedAge is age[x] is present"/>
        <expression value="age.exists() or estimatedAge.empty()"/>
        <xpath
               value="exists(*[starts-with(local-name(.), 'age')]) or not(exists(f:estimatedAge))"/>
      </constraint>
      <constraint>
        <key value="fhs-1"/>
        <severity value="error"/>
        <human value="Can have age[x] or born[x], but not both"/>
        <expression value="age.empty() or born.empty()"/>
        <xpath
               value="not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')])"/>
      </constraint>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="Not in scope for v2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="Diagnosis, Family History"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.id">
      <path value="FamilyMemberHistory.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comments
                value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.meta">
      <path value="FamilyMemberHistory.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.implicitRules">
      <path value="FamilyMemberHistory.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comments
                value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.language">
      <path value="FamilyMemberHistory.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments
                value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.text">
      <path value="FamilyMemberHistory.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comments
                value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.contained">
      <path value="FamilyMemberHistory.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comments
                value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.extension">
      <path value="FamilyMemberHistory.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.modifierExtension">
      <path value="FamilyMemberHistory.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.identifier">
      <path value="FamilyMemberHistory.identifier"/>
      <short value="External Id(s) for this record"/>
      <definition
                  value="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)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="FamilyMemberHistory.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.patient">
      <path value="FamilyMemberHistory.patient"/>
      <short value="Patient history is about"/>
      <definition value="The person who this history concerns."/>
      <alias value="Proband"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.patient"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.date">
      <path value="FamilyMemberHistory.date"/>
      <short value="When history was captured/updated"/>
      <definition
                  value="The date (and possibly time) when the family member history was taken."/>
      <comments
                value="This should be captured even if the same as the date on the List aggregating the full family history."/>
      <requirements value="Allows determination of how current the summary is."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.date"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.status">
      <path value="FamilyMemberHistory.status"/>
      <short value="partial | completed | entered-in-error | health-unknown"/>
      <definition
                  value="A code specifying the status of the record of the family history of a specific family member."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="A code that identifies the status of the family history record."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/history-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.name">
      <path value="FamilyMemberHistory.name"/>
      <short value="The family member described"/>
      <definition
                  value="This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair"."/>
      <requirements
                    value="Allows greater ease in ensuring the same person is being talked about."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="name"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.relationship">
      <path value="FamilyMemberHistory.relationship"/>
      <short value="Relationship to the subject"/>
      <definition
                  value="The type of relationship this person has to the patient (father, mother, brother etc.)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.relationship"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="The nature of the relationship between the patient and the related person being described in the family member history."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-FamilyMember"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.gender">
      <path value="FamilyMemberHistory.gender"/>
      <short value="male | female | other | unknown"/>
      <definition
                  value="Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposes."/>
      <requirements
                    value="Not all relationship codes imply gender and the relative's gender can be relevant for risk assessments."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.gender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="The gender of a person used for administrative purposes."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.born[x]">
      <path value="FamilyMemberHistory.born[x]"/>
      <short value="(approximate) date of birth"/>
      <definition
                  value="The actual or approximate date of birth of the relative."/>
      <requirements value="Allows calculation of the relative's age."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.born[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <condition value="fhs-1"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=LIV, determinerCode=INSTANCE]. birthDate (could be URG)"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.age[x]">
      <path value="FamilyMemberHistory.age[x]"/>
      <short value="(approximate) age"/>
      <definition
                  value="The age of the relative at the time the family member history is recorded."/>
      <comments
                value="use estimatedAge to indicate whether the age is actual or not."/>
      <requirements
                    value="While age can be calculated from date of birth, sometimes recording age directly is more natureal for clinicians."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.age[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <condition value="fhs-1"/>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="participation[typeCode=SBJ].act[classCode=OBS,moodCode=EVN, code="age"].value"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.estimatedAge">
      <path value="FamilyMemberHistory.estimatedAge"/>
      <short value="Age is estimated?"/>
      <definition
                  value="If true, indicates that the age value specified is an estimated value."/>
      <requirements
                    value="Clinicians often prefer to specify an estimaged age rather than an age range."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.estimatedAge"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <meaningWhenMissing
                          value="It is unknown whether the age is an estimate or not"/>
      <condition value="fhs-2"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.deceased[x]">
      <path value="FamilyMemberHistory.deceased[x]"/>
      <short value="Dead? How old/when?"/>
      <definition
                  value="Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.deceased[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG)  For age, you'd hang an observation off the role"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.note">
      <path value="FamilyMemberHistory.note"/>
      <short value="General note about related person"/>
      <definition
                  value="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 possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.note"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition">
      <path value="FamilyMemberHistory.condition"/>
      <short value="Condition that the related person had"/>
      <definition
                  value="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 condition."/>
      <comments
                value="If none of the conditions listed have an outcome of "death" specified, that indicates that none of the specified conditions are known to have been the primary cause of death."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="FamilyMemberHistory.condition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition.id">
      <path value="FamilyMemberHistory.condition.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.extension">
      <path value="FamilyMemberHistory.condition.extension"/>
      <slicing id="6">
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.extension:familymemberhistoryconditionabatement$familymemberhistory-abatement">
      <path value="FamilyMemberHistory.condition.extension"/>
      <name value="FamilyMemberHistory.condition.abatement"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="children().count() > id.count()"/>
        <xpath value="@value|f:*|h:div"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="stop datetime"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.extension:familymemberhistoryconditionseverity$familymemberhistory-severity">
      <path value="FamilyMemberHistory.condition.extension"/>
      <name value="FamilyMemberHistory.condition.severity"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="children().count() > id.count()"/>
        <xpath value="@value|f:*|h:div"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="Valueset to identify the severity of the problem"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="severity"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.modifierExtension">
      <path value="FamilyMemberHistory.condition.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition.code">
      <path value="FamilyMemberHistory.condition.code"/>
      <short value="Condition suffered by relation"/>
      <definition
                  value="The 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 system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.condition.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="The code for the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/daf/ValueSet/daf-problem"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.outcome">
      <path value="FamilyMemberHistory.condition.outcome"/>
      <short value="deceased | permanent disability | etc."/>
      <definition
                  value="Indicates what happened as a result of this condition.  If the condition resulted in death, deceased date is captured on the relation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.condition.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description
                     value="The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-outcome"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.onset[x]">
      <path value="FamilyMemberHistory.condition.onset[x]"/>
      <short value="When condition first manifested"/>
      <definition
                  value="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 occurrence."/>
      <requirements
                    value="Age of onset of a condition in relatives is predictive of risk for the patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.condition.onset[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="Subject Age at measurement", value<Diagnosis].value[@xsi:typeCode='TS' or 'IVL_TS']  Use originalText for string"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition.note">
      <path value="FamilyMemberHistory.condition.note"/>
      <short value="Extra information about condition"/>
      <definition
                  value="An area where general notes can be placed about this specific condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="FamilyMemberHistory.condition.note"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="FamilyMemberHistory:qicore-familymemberhistory">
      <path value="FamilyMemberHistory"/>
      <name value="QICore-FamilyMemberHistory"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="Diagnosis, Family History"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.patient">
      <path value="FamilyMemberHistory.patient"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.date">
      <path value="FamilyMemberHistory.date"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.relationship">
      <path value="FamilyMemberHistory.relationship"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.age[x]">
      <path value="FamilyMemberHistory.age[x]"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.deceased[x]">
      <path value="FamilyMemberHistory.deceased[x]"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition">
      <path value="FamilyMemberHistory.condition"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.extension:familymemberhistoryconditionabatement$familymemberhistory-abatement">
      <path value="FamilyMemberHistory.condition.extension"/>
      <name value="FamilyMemberHistory.condition.abatement"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="stop datetime"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.extension:familymemberhistoryconditionseverity$familymemberhistory-severity">
      <path value="FamilyMemberHistory.condition.extension"/>
      <name value="FamilyMemberHistory.condition.severity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="Valueset to identify the severity of the problem"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="severity"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.outcome">
      <path value="FamilyMemberHistory.condition.outcome"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="status"/>
      </mapping>
    </element>
    <element
             id="FamilyMemberHistory:qicore-familymemberhistory.condition.onset[x]">
      <path value="FamilyMemberHistory.condition.onset[x]"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime"/>
      </mapping>
    </element>
    <element id="FamilyMemberHistory:qicore-familymemberhistory.condition.code">
      <path value="FamilyMemberHistory.condition.code"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="The code for the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/daf/ValueSet/daf-problem"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>