FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). 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

Patient Care Work GroupMaturity Level: 2 Trial UseCompartments: Patient

Detailed Descriptions for the elements in the FamilyMemberHistory resource.

FamilyMemberHistory
Definition

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

Control1..1
InvariantsDefined on this element
fhs-1: Can have age[x] or born[x], but not both (expression : age.empty() or born.empty(), xpath: not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')]))
fhs-2: Can only have estimatedAge if age[x] is present (expression : age.exists() or estimatedAge.empty(), xpath: exists(*[starts-with(local-name(.), 'age')]) or not(exists(f:estimatedAge)))
fhs-3: Not Done Reason can only be specified if NotDone is "true" (expression : notDone or notDoneReason.exists().not(), xpath: f:notDone/@value=true() or not(exists(f:notDoneReason)))
FamilyMemberHistory.identifier
Definition

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).

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Need to allow connection to a wider workflow.

Summarytrue
FamilyMemberHistory.definition
Definition

A protocol or questionnaire that was adhered to in whole or in part by this event.

Control0..*
TypeReference(PlanDefinition | Questionnaire)
Summarytrue
FamilyMemberHistory.status
Definition

A code specifying the status of the record of the family history of a specific family member.

Control1..1
Terminology BindingFamilyHistoryStatus (Required)
Typecode
Is Modifiertrue
Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

FamilyMemberHistory.notDone
Definition

If true, indicates the taking of an individual family member's history did not occur. The notDone element should not be used to document negated conditions, such as a family member that did not have a condition.

Control0..1
Typeboolean
Is Modifiertrue
Default Valuefalse
Requirements

Creating a FamilyMemberHistory where notDone is true is intended for situations where there's a need for a specific statement in the record about something not being done. If the need is merely to indicate that a request wasn't fulfilled, that should be handled using Task.

Summarytrue
Comments

This element is labeled as a modifier because it marks the family member history as a family member history that did not occur. The more attributes are populated, the more constrained the negated statement is. This notDone element is being evaluated and will likely be removed in a subsequent release.

FamilyMemberHistory.notDoneReason
Definition

Describes why the family member's history is absent.

Control0..1
Terminology BindingFamilyHistoryNotDoneReason (Example)
TypeCodeableConcept
Requirements

This is a separate element to allow it to have a distinct binding from reasonCode.

Summarytrue
Comments

This notDoneReason element is being evaluated and will likely be replaced in a subsequent release (e.g. dataAbsentReason).

InvariantsAffect this element
fhs-3: Not Done Reason can only be specified if NotDone is "true" (expression : notDone or notDoneReason.exists().not(), xpath: f:notDone/@value=true() or not(exists(f:notDoneReason)))
FamilyMemberHistory.patient
Definition

The person who this history concerns.

Control1..1
TypeReference(Patient)
Alternate NamesProband
Summarytrue
FamilyMemberHistory.date
Definition

The date (and possibly time) when the family member history was taken.

Control0..1
TypedateTime
Requirements

Allows determination of how current the summary is.

Summarytrue
Comments

This should be captured even if the same as the date on the List aggregating the full family history.

FamilyMemberHistory.name
Definition

This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair".

Control0..1
Typestring
Requirements

Allows greater ease in ensuring the same person is being talked about.

Summarytrue
FamilyMemberHistory.relationship
Definition

The type of relationship this person has to the patient (father, mother, brother etc.).

Control1..1
Terminology BindingFamilyMember (Example)
TypeCodeableConcept
Summarytrue
FamilyMemberHistory.gender
Definition

Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposes.

Control0..1
Terminology BindingAdministrativeGender (Required)
Typecode
Requirements

Not all relationship codes imply gender and the relative's gender can be relevant for risk assessments.

Summarytrue
FamilyMemberHistory.born[x]
Definition

The actual or approximate date of birth of the relative.

Control0..1
TypePeriod|date|string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

Allows calculation of the relative's age.

InvariantsAffect this element
fhs-1: Can have age[x] or born[x], but not both (expression : age.empty() or born.empty(), xpath: not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')]))
FamilyMemberHistory.age[x]
Definition

The age of the relative at the time the family member history is recorded.

Control0..1
TypeAge|Range|string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

While age can be calculated from date of birth, sometimes recording age directly is more natureal for clinicians.

Summarytrue
Comments

use estimatedAge to indicate whether the age is actual or not.

InvariantsAffect this element
fhs-1: Can have age[x] or born[x], but not both (expression : age.empty() or born.empty(), xpath: not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')]))
FamilyMemberHistory.estimatedAge
Definition

If true, indicates that the age value specified is an estimated value.

Control0..1
Typeboolean
Is Modifiertrue
Meaning if MissingIt is unknown whether the age is an estimate or not
Requirements

Clinicians often prefer to specify an estimaged age rather than an age range.

Summarytrue
Comments

This element is labeled as a modifier because the fact tha age is estimated can/should change the results of any algorithm that calculates based on the specified age.

InvariantsAffect this element
fhs-2: Can only have estimatedAge if age[x] is present (expression : age.exists() or estimatedAge.empty(), xpath: exists(*[starts-with(local-name(.), 'age')]) or not(exists(f:estimatedAge)))
FamilyMemberHistory.deceased[x]
Definition

Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.

Control0..1
Typeboolean|Age|Range|date|string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
FamilyMemberHistory.reasonCode
Definition

Describes why the family member history occurred in coded or textual form.

Control0..*
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
Summarytrue
Comments

Textual reasons can be caprued using reasonCode.text.

FamilyMemberHistory.reasonReference
Definition

Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.

Control0..*
TypeReference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse)
Summarytrue
FamilyMemberHistory.note
Definition

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.

Control0..*
TypeAnnotation
FamilyMemberHistory.condition
Definition

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.

Control0..*
Comments

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.

FamilyMemberHistory.condition.code
Definition

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.

Control1..1
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableConcept
FamilyMemberHistory.condition.outcome
Definition

Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relation.

Control0..1
Terminology BindingCondition Outcome Codes (Example)
TypeCodeableConcept
FamilyMemberHistory.condition.onset[x]
Definition

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.

Control0..1
TypeAge|Range|Period|string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

Age of onset of a condition in relatives is predictive of risk for the patient.

FamilyMemberHistory.condition.note
Definition

An area where general notes can be placed about this specific condition.

Control0..*
TypeAnnotation