Current Build
Patient Care Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Patient

Detailed Descriptions for the elements in the FamilyMemberHistory resource.

FamilyMemberHistory
Element IdFamilyMemberHistory
Definition

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

Cardinality0..*
TypeDomainResource
Invariants
Defined on this element
fhs-1Rule Can have age[x] or born[x], but not bothage.empty() or born.empty()
fhs-2Rule Can only have estimatedAge if age[x] is presentage.exists() or estimatedAge.empty()
FamilyMemberHistory.identifier
Element IdFamilyMemberHistory.identifier
Definition

Business identifiers assigned to this family member history by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows identification of the family member history as it is known by various participating systems and in a way that remains consistent across servers.

Summarytrue
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

FamilyMemberHistory.instantiatesCanonical
Element IdFamilyMemberHistory.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistory.

Cardinality0..*
Typecanonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition)
Summarytrue
FamilyMemberHistory.instantiatesUri
Element IdFamilyMemberHistory.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistory.

Cardinality0..*
Typeuri
Summarytrue
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

FamilyMemberHistory.status
Element IdFamilyMemberHistory.status
Definition

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

Cardinality1..1
Terminology BindingFamilyHistoryStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

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

FamilyMemberHistory.dataAbsentReason
Element IdFamilyMemberHistory.dataAbsentReason
Definition

Describes why the family member's history is not available.

Cardinality0..1
Terminology BindingFamilyHistoryAbsentReason (Example)
TypeCodeableConcept
Requirements

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

Summarytrue
FamilyMemberHistory.patient
Element IdFamilyMemberHistory.patient
Definition

The person who this history concerns.

Cardinality1..1
TypeReference(Patient)
Alternate NamesProband
Summarytrue
FamilyMemberHistory.date
Element IdFamilyMemberHistory.date
Definition

The date (and possibly time) when the family member history was recorded or last updated.

Cardinality0..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
Element IdFamilyMemberHistory.name
Definition

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

Cardinality0..1
Typestring
Requirements

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

Summarytrue
FamilyMemberHistory.relationship
Element IdFamilyMemberHistory.relationship
Definition

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

Cardinality1..1
Terminology BindingV3 Value SetFamilyMember (Example)
TypeCodeableConcept
Summarytrue
FamilyMemberHistory.sex
Element IdFamilyMemberHistory.sex
Definition

The birth sex of the family member.

Cardinality0..1
Terminology BindingAdministrativeGender (Extensible)
TypeCodeableConcept
Requirements

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

Summarytrue
Comments

This element should ideally reflect whether the individual is genetically male or female. However, as reported information based on the knowledge of the patient or reporting friend/relative, there may be situations where the reported sex might not be totally accurate. E.g. 'Aunt Sue' might be XY rather than XX. Questions soliciting this information should be phrased to encourage capture of genetic sex where known. However, systems performing analysis should also allow for the possibility of imprecision with this element.

FamilyMemberHistory.born[x]
Element IdFamilyMemberHistory.born[x]
Definition

The actual or approximate date of birth of the relative.

Cardinality0..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.

Invariants
Affect this element
fhs-1Rule Can have age[x] or born[x], but not bothage.empty() or born.empty()
FamilyMemberHistory.age[x]
Element IdFamilyMemberHistory.age[x]
Definition

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

Cardinality0..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 natural for clinicians.

Summarytrue
Comments

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

Invariants
Affect this element
fhs-1Rule Can have age[x] or born[x], but not bothage.empty() or born.empty()
FamilyMemberHistory.estimatedAge
Element IdFamilyMemberHistory.estimatedAge
Definition

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

Cardinality0..1
Typeboolean
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 that age is estimated can/should change the results of any algorithm that calculates based on the specified age.

Invariants
Affect this element
fhs-2Rule Can only have estimatedAge if age[x] is presentage.exists() or estimatedAge.empty()
FamilyMemberHistory.deceased[x]
Element IdFamilyMemberHistory.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.

Cardinality0..1
Typeboolean|Age|Range|date|string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
FamilyMemberHistory.reasonCode
Element IdFamilyMemberHistory.reasonCode
Definition

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

Cardinality0..*
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
Summarytrue
Comments

Textual reasons can be captured using reasonCode.text.

FamilyMemberHistory.reasonReference
Element IdFamilyMemberHistory.reasonReference
Definition

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

Cardinality0..*
TypeReference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference)
PatternsReference(Condition,Observation,AllergyIntolerance,QuestionnaireResponse,DiagnosticReport,DocumentReference): No common pattern
Summarytrue
FamilyMemberHistory.note
Element IdFamilyMemberHistory.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.

Cardinality0..*
TypeAnnotation
FamilyMemberHistory.condition
Element IdFamilyMemberHistory.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.

Cardinality0..*
FamilyMemberHistory.condition.code
Element IdFamilyMemberHistory.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.

Cardinality1..1
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableConcept
FamilyMemberHistory.condition.outcome
Element IdFamilyMemberHistory.condition.outcome
Definition

Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation.

Cardinality0..1
Terminology BindingCondition Outcome Codes (Example)
TypeCodeableConcept
FamilyMemberHistory.condition.contributedToDeath
Element IdFamilyMemberHistory.condition.contributedToDeath
Definition

This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.

Cardinality0..1
Typeboolean
FamilyMemberHistory.condition.onset[x]
Element IdFamilyMemberHistory.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.

Cardinality0..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
Element IdFamilyMemberHistory.condition.note
Definition

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

Cardinality0..*
TypeAnnotation
FamilyMemberHistory.procedure
Element IdFamilyMemberHistory.procedure
Definition

The significant Procedures (or procedure) that the family member had. This is a repeating section to allow a system to represent more than one procedure per resource, though there is nothing stopping multiple resources - one per procedure.

Cardinality0..*
FamilyMemberHistory.procedure.code
Element IdFamilyMemberHistory.procedure.code
Definition

The actual procedure specified. Could be a coded procedure or a less specific string depending on how much is known about the procedure and the capabilities of the creating system.

Cardinality1..1
Terminology BindingProcedure Codes (SNOMED CT) (Example)
TypeCodeableConcept
FamilyMemberHistory.procedure.outcome
Element IdFamilyMemberHistory.procedure.outcome
Definition

Indicates what happened following the procedure. If the procedure resulted in death, deceased date is captured on the relation.

Cardinality0..1
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
FamilyMemberHistory.procedure.contributedToDeath
Element IdFamilyMemberHistory.procedure.contributedToDeath
Definition

This procedure contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.

Cardinality0..1
Typeboolean
FamilyMemberHistory.procedure.performed[x]
Element IdFamilyMemberHistory.procedure.performed[x]
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Cardinality0..1
TypeAge|Range|Period|string|dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
FamilyMemberHistory.procedure.note
Element IdFamilyMemberHistory.procedure.note
Definition

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

Cardinality0..*
TypeAnnotation