This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions

9.4 Resource FamilyMemberHistory - Content

Patient Care icon

Work Group

Maturity Level: 2

Trial Use

Security 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

Implements: Event
Resource References: AdverseEvent
Extension References: FamilyMemberHistory Parent, FamilyMemberHistory Sibling and Procedure Caused By

Structure

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	TU		DomainResource	Information about patient's relatives, relevant for patient + Rule: Can have age[x] or born[x], but not both + Rule: Can only have estimatedAge if age[x] is present + Rule: Can have age[x] or deceased[x], but not both Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| Questionnaire \| ActivityDefinition \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial \| completed \| entered-in-error \| health-unknown Binding: Family History Status (Required)
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown \| withheld \| unable-to-obtain \| deferred Binding: Family History Absent Reason (Example)
patient	Σ	1..1	Reference(Patient)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
participant	Σ	0..*	BackboneElement	Who or what participated in the activities related to the family member history and how they were involved
function	Σ	0..1	CodeableConcept	Type of involvement Binding: Participation Role Type (Extensible)
actor	Σ	1..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Device \| Organization \| CareTeam)	Who or what participated in the activities related to the family member history
name	Σ	0..1	string	The family member described
relationship	Σ	1..1	CodeableConcept	Relationship to the subject Binding: FamilyMember (Example)
sex	Σ	0..1	CodeableConcept	male \| female \| other \| unknown Binding: AdministrativeGender (Extensible)
born[x]	C	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	Σ C	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	Σ C	0..1	boolean	Age is estimated?
deceased[x]	Σ C	0..1		Dead? How old/when?
deceasedBoolean			boolean
deceasedAge			Age
deceasedRange			Range
deceasedDate			date
deceasedString			string
reason	Σ	0..*	CodeableReference(Condition \| Observation \| AllergyIntolerance \| QuestionnaireResponse \| DiagnosticReport \| DocumentReference)	Why was family member history performed? Binding: SNOMED CT Clinical Findings (Example)
note		0..*	Annotation	General note about related person
condition		0..*	BackboneElement	Condition that the related person had
code		1..1	CodeableConcept	Condition, allergy, or intolerance suffered by relation Binding: Condition/Problem/Diagnosis Codes (Example)
outcome		0..1	CodeableConcept	deceased \| permanent disability \| etc Binding: Condition Outcome Codes (Example)
contributedToDeath		0..1	boolean	Whether the condition contributed to the cause of death
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
procedure		0..*	BackboneElement	Procedures that the related person had
code		1..1	CodeableConcept	Procedures performed on the related person Binding: Procedure Codes (SNOMED CT) (Example)
outcome		0..1	CodeableConcept	What happened following the procedure Binding: SNOMED CT Clinical Findings (Example)
contributedToDeath		0..1	boolean	Whether the procedure contributed to the cause of death
performed[x]		0..1		When the procedure was performed
performedAge			Age
performedRange			Range
performedPeriod			Period
performedString			string
performedDateTime			dateTime
note		0..*	Annotation	Extra information about the procedure
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(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 -->
 <participant>  <!-- 0..* Who or what participated in the activities related to the family member history and how they were involved -->
  <function><!-- 0..1 CodeableConcept Type of involvement --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who or what participated in the activities related to the family member history --></actor>
 </participant>
 <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]><!-- I 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, allergy, or intolerance 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

{
  "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
  "participant" : [{ // Who or what participated in the activities related to the family member history and how they were involved
    "function" : { CodeableConcept }, // Type of involvement
    "actor" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // R!  Who or what participated in the activities related to the family member history
  }],
  "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, allergy, or intolerance 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/> .


[ 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:identifier  ( [ Identifier ] ... ) ; # 0..* External Id(s) for this record
  fhir:instantiatesCanonical  ( [ canonical(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ] ... ) ; # 0..* Instantiates FHIR protocol or definition
  fhir:instantiatesUri  ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition
  fhir:status [ code ] ; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:dataAbsentReason [ CodeableConcept ] ; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:patient [ Reference(Patient) ] ; # 1..1 Patient history is about
  fhir:date [ dateTime ] ; # 0..1 When history was recorded or last updated
  fhir:participant ( [ # 0..* Who or what participated in the activities related to the family member history and how they were involved
    fhir:function [ CodeableConcept ] ; # 0..1 Type of involvement
    fhir:actor [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Who or what participated in the activities related to the family member history
  ] ... ) ;
  fhir:name [ string ] ; # 0..1 The family member described
  fhir:relationship [ CodeableConcept ] ; # 1..1 Relationship to the subject
  fhir:sex [ CodeableConcept ] ; # 0..1 male | female | other | unknown
  # born[x] : 0..1 I (approximate) date of birth. One of these 3
    fhir:born [  a fhir:Period ; Period ]
    fhir:born [  a fhir:date ; date ]
    fhir:born [  a fhir:string ; string ]
  # age[x] : 0..1 I (approximate) age. One of these 3
    fhir:age [  a fhir:Age ; Age ]
    fhir:age [  a fhir:Range ; Range ]
    fhir:age [  a fhir:string ; string ]
  fhir:estimatedAge [ boolean ] ; # 0..1 I Age is estimated?
  # deceased[x] : 0..1 I Dead? How old/when?. One of these 5
    fhir:deceased [  a fhir:boolean ; boolean ]
    fhir:deceased [  a fhir:Age ; Age ]
    fhir:deceased [  a fhir:Range ; Range ]
    fhir:deceased [  a fhir:date ; date ]
    fhir:deceased [  a fhir:string ; string ]
  fhir:reason  ( [ CodeableReference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ] ... ) ; # 0..* Why was family member history performed?
  fhir:note  ( [ Annotation ] ... ) ; # 0..* General note about related person
  fhir:condition ( [ # 0..* Condition that the related person had
    fhir:code [ CodeableConcept ] ; # 1..1 Condition, allergy, or intolerance suffered by relation
    fhir:outcome [ CodeableConcept ] ; # 0..1 deceased | permanent disability | etc
    fhir:contributedToDeath [ boolean ] ; # 0..1 Whether the condition contributed to the cause of death
    # onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:onset [  a fhir:Age ; Age ]
      fhir:onset [  a fhir:Range ; Range ]
      fhir:onset [  a fhir:Period ; Period ]
      fhir:onset [  a fhir:string ; string ]
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Extra information about condition
  ] ... ) ;
  fhir:procedure ( [ # 0..* Procedures that the related person had
    fhir:code [ CodeableConcept ] ; # 1..1 Procedures performed on the related person
    fhir:outcome [ CodeableConcept ] ; # 0..1 What happened following the procedure
    fhir:contributedToDeath [ boolean ] ; # 0..1 Whether the procedure contributed to the cause of death
    # performed[x] : 0..1 When the procedure was performed. One of these 5
      fhir:performed [  a fhir:Age ; Age ]
      fhir:performed [  a fhir:Range ; Range ]
      fhir:performed [  a fhir:Period ; Period ]
      fhir:performed [  a fhir:string ; string ]
      fhir:performed [  a fhir:dateTime ; dateTime ]
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Extra information about the procedure
  ] ... ) ;
]

Changes from both R4 and R4B

FamilyMemberHistory

FamilyMemberHistory.participant

Added Element

FamilyMemberHistory.participant.function

Added Element

FamilyMemberHistory.participant.actor

Added Mandatory Element

FamilyMemberHistory.sex

Change value set from http://build.fhir.org/valueset-administrative-gender.html to AdministrativeGender

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.reason)

FamilyMemberHistory.reasonReference

Deleted (-> FamilyMemberHistory.reason)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	TU		DomainResource	Information about patient's relatives, relevant for patient + Rule: Can have age[x] or born[x], but not both + Rule: Can only have estimatedAge if age[x] is present + Rule: Can have age[x] or deceased[x], but not both Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| Questionnaire \| ActivityDefinition \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial \| completed \| entered-in-error \| health-unknown Binding: Family History Status (Required)
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown \| withheld \| unable-to-obtain \| deferred Binding: Family History Absent Reason (Example)
patient	Σ	1..1	Reference(Patient)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
participant	Σ	0..*	BackboneElement	Who or what participated in the activities related to the family member history and how they were involved
function	Σ	0..1	CodeableConcept	Type of involvement Binding: Participation Role Type (Extensible)
actor	Σ	1..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Device \| Organization \| CareTeam)	Who or what participated in the activities related to the family member history
name	Σ	0..1	string	The family member described
relationship	Σ	1..1	CodeableConcept	Relationship to the subject Binding: FamilyMember (Example)
sex	Σ	0..1	CodeableConcept	male \| female \| other \| unknown Binding: AdministrativeGender (Extensible)
born[x]	C	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	Σ C	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	Σ C	0..1	boolean	Age is estimated?
deceased[x]	Σ C	0..1		Dead? How old/when?
deceasedBoolean			boolean
deceasedAge			Age
deceasedRange			Range
deceasedDate			date
deceasedString			string
reason	Σ	0..*	CodeableReference(Condition \| Observation \| AllergyIntolerance \| QuestionnaireResponse \| DiagnosticReport \| DocumentReference)	Why was family member history performed? Binding: SNOMED CT Clinical Findings (Example)
note		0..*	Annotation	General note about related person
condition		0..*	BackboneElement	Condition that the related person had
code		1..1	CodeableConcept	Condition, allergy, or intolerance suffered by relation Binding: Condition/Problem/Diagnosis Codes (Example)
outcome		0..1	CodeableConcept	deceased \| permanent disability \| etc Binding: Condition Outcome Codes (Example)
contributedToDeath		0..1	boolean	Whether the condition contributed to the cause of death
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
procedure		0..*	BackboneElement	Procedures that the related person had
code		1..1	CodeableConcept	Procedures performed on the related person Binding: Procedure Codes (SNOMED CT) (Example)
outcome		0..1	CodeableConcept	What happened following the procedure Binding: SNOMED CT Clinical Findings (Example)
contributedToDeath		0..1	boolean	Whether the procedure contributed to the cause of death
performed[x]		0..1		When the procedure was performed
performedAge			Age
performedRange			Range
performedPeriod			Period
performedString			string
performedDateTime			dateTime
note		0..*	Annotation	Extra information about the procedure
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(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 -->
 <participant>  <!-- 0..* Who or what participated in the activities related to the family member history and how they were involved -->
  <function><!-- 0..1 CodeableConcept Type of involvement --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who or what participated in the activities related to the family member history --></actor>
 </participant>
 <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]><!-- I 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, allergy, or intolerance 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

{
  "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
  "participant" : [{ // Who or what participated in the activities related to the family member history and how they were involved
    "function" : { CodeableConcept }, // Type of involvement
    "actor" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // R!  Who or what participated in the activities related to the family member history
  }],
  "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, allergy, or intolerance 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/> .


[ 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:identifier  ( [ Identifier ] ... ) ; # 0..* External Id(s) for this record
  fhir:instantiatesCanonical  ( [ canonical(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ] ... ) ; # 0..* Instantiates FHIR protocol or definition
  fhir:instantiatesUri  ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition
  fhir:status [ code ] ; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:dataAbsentReason [ CodeableConcept ] ; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:patient [ Reference(Patient) ] ; # 1..1 Patient history is about
  fhir:date [ dateTime ] ; # 0..1 When history was recorded or last updated
  fhir:participant ( [ # 0..* Who or what participated in the activities related to the family member history and how they were involved
    fhir:function [ CodeableConcept ] ; # 0..1 Type of involvement
    fhir:actor [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Who or what participated in the activities related to the family member history
  ] ... ) ;
  fhir:name [ string ] ; # 0..1 The family member described
  fhir:relationship [ CodeableConcept ] ; # 1..1 Relationship to the subject
  fhir:sex [ CodeableConcept ] ; # 0..1 male | female | other | unknown
  # born[x] : 0..1 I (approximate) date of birth. One of these 3
    fhir:born [  a fhir:Period ; Period ]
    fhir:born [  a fhir:date ; date ]
    fhir:born [  a fhir:string ; string ]
  # age[x] : 0..1 I (approximate) age. One of these 3
    fhir:age [  a fhir:Age ; Age ]
    fhir:age [  a fhir:Range ; Range ]
    fhir:age [  a fhir:string ; string ]
  fhir:estimatedAge [ boolean ] ; # 0..1 I Age is estimated?
  # deceased[x] : 0..1 I Dead? How old/when?. One of these 5
    fhir:deceased [  a fhir:boolean ; boolean ]
    fhir:deceased [  a fhir:Age ; Age ]
    fhir:deceased [  a fhir:Range ; Range ]
    fhir:deceased [  a fhir:date ; date ]
    fhir:deceased [  a fhir:string ; string ]
  fhir:reason  ( [ CodeableReference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ] ... ) ; # 0..* Why was family member history performed?
  fhir:note  ( [ Annotation ] ... ) ; # 0..* General note about related person
  fhir:condition ( [ # 0..* Condition that the related person had
    fhir:code [ CodeableConcept ] ; # 1..1 Condition, allergy, or intolerance suffered by relation
    fhir:outcome [ CodeableConcept ] ; # 0..1 deceased | permanent disability | etc
    fhir:contributedToDeath [ boolean ] ; # 0..1 Whether the condition contributed to the cause of death
    # onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:onset [  a fhir:Age ; Age ]
      fhir:onset [  a fhir:Range ; Range ]
      fhir:onset [  a fhir:Period ; Period ]
      fhir:onset [  a fhir:string ; string ]
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Extra information about condition
  ] ... ) ;
  fhir:procedure ( [ # 0..* Procedures that the related person had
    fhir:code [ CodeableConcept ] ; # 1..1 Procedures performed on the related person
    fhir:outcome [ CodeableConcept ] ; # 0..1 What happened following the procedure
    fhir:contributedToDeath [ boolean ] ; # 0..1 Whether the procedure contributed to the cause of death
    # performed[x] : 0..1 When the procedure was performed. One of these 5
      fhir:performed [  a fhir:Age ; Age ]
      fhir:performed [  a fhir:Range ; Range ]
      fhir:performed [  a fhir:Period ; Period ]
      fhir:performed [  a fhir:string ; string ]
      fhir:performed [  a fhir:dateTime ; dateTime ]
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Extra information about the procedure
  ] ... ) ;
]

Changes from both R4 and R4B

FamilyMemberHistory

FamilyMemberHistory.participant

Added Element

FamilyMemberHistory.participant.function

Added Element

FamilyMemberHistory.participant.actor

Added Mandatory Element

FamilyMemberHistory.sex

Change value set from http://build.fhir.org/valueset-administrative-gender.html to AdministrativeGender

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.reason)

FamilyMemberHistory.reasonReference

Deleted (-> FamilyMemberHistory.reason)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

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

Path	ValueSet	Type	Documentation
FamilyMemberHistory.status	FamilyHistoryStatus	Required	A code that identifies the status of the family history record.
FamilyMemberHistory.dataAbsentReason	FamilyHistoryAbsentReason	Example	Codes describing the reason why a family member's history is not available.
FamilyMemberHistory.participant.function	ParticipationRoleType	Extensible	This FHIR value set is comprised of Actor participation Type codes, which can be used to value FHIR agents, actors, and other role elements. The codes are intended to express how the agent participated in some activity. Sometimes refered to the agent functional-role relative to the activity.
FamilyMemberHistory.relationship	FamilyMember	Example	A relationship between two people characterizing their "familial" relationship
FamilyMemberHistory.sex	AdministrativeGender	Extensible	The gender of a person used for administrative purposes.
FamilyMemberHistory.reason	SNOMEDCTClinicalFindings	Example	This value set includes all the "Clinical finding" SNOMED CT codes - concepts where concept is-a 404684003 (Clinical finding (finding)).
FamilyMemberHistory.condition.code	ConditionProblemDiagnosisCodes	Example	Example value set for Condition/Problem/Diagnosis codes.
FamilyMemberHistory.condition.outcome	ConditionOutcomeCodes	Example	Example value set for condition outcomes.
FamilyMemberHistory.procedure.code	ProcedureCodesSNOMEDCT	Example	Procedure Code: All SNOMED CT procedure codes.
FamilyMemberHistory.procedure.outcome	SNOMEDCTClinicalFindings	Example	This value set includes all the "Clinical finding" SNOMED CT codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

Path

ValueSet

Type

Documentation

FamilyMemberHistory.status

FamilyHistoryStatus

Required

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

FamilyMemberHistory.dataAbsentReason

FamilyHistoryAbsentReason

Example

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

FamilyMemberHistory.participant.function

ParticipationRoleType

Extensible

This FHIR value set is comprised of Actor participation Type codes, which can be used to value FHIR agents, actors, and other role elements. The codes are intended to express how the agent participated in some activity. Sometimes refered to the agent functional-role relative to the activity.

FamilyMemberHistory.relationship

FamilyMember icon

Example

A relationship between two people characterizing their "familial" relationship

FamilyMemberHistory.sex

AdministrativeGender

Extensible

The gender of a person used for administrative purposes.

FamilyMemberHistory.reason

SNOMEDCTClinicalFindings

Example

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

FamilyMemberHistory.condition.code

ConditionProblemDiagnosisCodes

Example

Example value set for Condition/Problem/Diagnosis codes.

FamilyMemberHistory.condition.outcome

ConditionOutcomeCodes

Example

Example value set for condition outcomes.

FamilyMemberHistory.procedure.code

ProcedureCodesSNOMEDCT

Example

Procedure Code: All SNOMED CT procedure codes.

FamilyMemberHistory.procedure.outcome

SNOMEDCTClinicalFindings

Example

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

9.4.3.2 Constraints

UniqueKey

Level

Location

Description

Expression

fhs-1

Rule

(base)

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

age.empty() or born.empty()

fhs-2

Rule

(base)

Can only have estimatedAge if age[x] is present

age.exists() or estimatedAge.empty()

fhs-3

Rule

(base)

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

age.empty() or deceased.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. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
code	token	A search by a condition code	FamilyMemberHistory.condition.code	22 Resources
date	date	When history was recorded or last updated	FamilyMemberHistory.date	26 Resources
identifier	token	A search by a record identifier	FamilyMemberHistory.identifier	65 Resources
instantiates-canonical	reference	Instantiates FHIR protocol or definition	FamilyMemberHistory.instantiatesCanonical (Questionnaire, Measure, PlanDefinition, OperationDefinition, ActivityDefinition)
instantiates-uri	uri	Instantiates external protocol or definition	FamilyMemberHistory.instantiatesUri
patient	reference	The identity of a subject to list family member history items for	FamilyMemberHistory.patient (Patient)	66 Resources
relationship	token	A search by a relationship type	FamilyMemberHistory.relationship
sex	token	A search by a sex code of a family member	FamilyMemberHistory.sex
status	token	partial \| completed \| entered-in-error \| health-unknown	FamilyMemberHistory.status