QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreFamilyMemberHistory

Defining URL: | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-familymemberhistory
Version: | 4.1.0
Name: | QICoreFamilyMemberHistory
Status: | Draft as of 8/22/18
Definition: | Profile of Family Member History for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
Publisher: | http://www.hl7.org/Special/committees/cqi/index.cfm
Source Resource: | XML / JSON / Turtle

The official URL for this profile is:

    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-familymemberhistory

Usage

See the patterns page for implementation and usage patterns.

### Examples

Father Died of Heart Attack Example

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from FamilyMemberHistory

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
- http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity

This structure is derived from FamilyMemberHistory

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
FamilyMemberHistory |  | 0..* | FamilyMemberHistory | Information about patient's relatives, relevant for patient
patient | S | 1..1 | Reference(QICorePatient) | Patient history is about
date | S | 0..1 | dateTime | When history was recorded or last updated
relationship | S | 1..1 | CodeableConcept | Relationship to the subject
age[x] | S | 0..1 | Age, Range, string | (approximate) age
deceased[x] | S | 0..1 | boolean, Age, Range, date, string | Dead? How old/when?
condition |  | 0..* | BackboneElement | Condition that the related person had
familymemberhistory-abatement |  | 0..1 | date, Age, boolean | When (or if) the family member's condition resolved URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
familymemberhistory-severity |  | 0..1 | CodeableConcept | The seriousness of the family member condition URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity Binding: Condition/DiagnosisSeverity (example): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S | 1..1 | CodeableConcept | Condition suffered by relation
onset[x] |  | 0..1 | Age, Range, Period, string | When condition first manifested
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
FamilyMemberHistory | I | 0..* | FamilyMemberHistory | Information about patient's relatives, relevant for patient
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
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: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
dataAbsentReason | Σ | 0..1 | CodeableConcept | subject-unknown | withheld | unable-to-obtain | deferred Binding: FamilyHistoryAbsentReason (example): Codes describing the reason why a family member's history is not available.
patient | S Σ | 1..1 | Reference(QICorePatient) | Patient history is about
date | S Σ | 0..1 | dateTime | When history was recorded or last updated
name | Σ | 0..1 | string | The family member described
relationship | S Σ | 1..1 | CodeableConcept | Relationship to the subject Binding: FamilyMember (example): The nature of the relationship between the patient and the related person being described in the family member history.
sex | Σ | 0..1 | CodeableConcept | male | female | other | unknown Binding: AdministrativeGender (extensible): Codes describing the sex assigned at birth as documented on the birth registration.
born[x] | I | 0..1 |  | (approximate) date of birth
bornPeriod |  |  | Period |
bornDate |  |  | date |
bornString |  |  | string |
age[x] | S Σ I | 0..1 |  | (approximate) age
ageAge |  |  | Age |
ageRange |  |  | Range |
ageString |  |  | string |
estimatedAge | Σ I | 0..1 | boolean | Age is estimated?
deceased[x] | S Σ | 0..1 |  | Dead? How old/when?
deceasedBoolean |  |  | boolean |
deceasedAge |  |  | Age |
deceasedRange |  |  | Range |
deceasedDate |  |  | date |
deceasedString |  |  | string |
reasonCode | Σ | 0..* | CodeableConcept | Why was family member history performed? Binding: SNOMEDCTClinicalFindings (example): Codes indicating why the family member history was done.
reasonReference | Σ | 0..* | Reference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference) | Why was family member history performed?
note |  | 0..* | Annotation | General note about related person
condition |  | 0..* | BackboneElement | Condition that the related person had
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
familymemberhistory-abatement |  | 0..1 | date, Age, boolean | When (or if) the family member's condition resolved URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
familymemberhistory-severity |  | 0..1 | CodeableConcept | The seriousness of the family member condition URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity Binding: Condition/DiagnosisSeverity (example): A subjective assessment of the severity of the condition as evaluated by the clinician.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | Condition suffered by relation Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
outcome |  | 0..1 | CodeableConcept | deceased | permanent disability | etc. Binding: ConditionOutcomeCodes (example): The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.
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
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
FamilyMemberHistory | I | 0..* | FamilyMemberHistory | Information about patient's relatives, relevant for patient
patient | Σ | 1..1 | Reference(QICorePatient) | Patient history is about
date | Σ | 0..1 | dateTime | When history was recorded or last updated
relationship | Σ | 1..1 | CodeableConcept | Relationship to the subject Binding: FamilyMember (example): The nature of the relationship between the patient and the related person being described in the family member history.
age[x] | Σ I | 0..1 |  | (approximate) age
ageAge |  |  | Age |
ageRange |  |  | Range |
ageString |  |  | string |
deceased[x] | Σ | 0..1 |  | Dead? How old/when?
deceasedBoolean |  |  | boolean |
deceasedAge |  |  | Age |
deceasedRange |  |  | Range |
deceasedDate |  |  | date |
deceasedString |  |  | string |
condition |  | 0..* | BackboneElement | Condition that the related person had
code |  | 1..1 | CodeableConcept | Condition suffered by relation Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
Documentation for this format

This structure is derived from FamilyMemberHistory

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
- http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity

Differential View

This structure is derived from FamilyMemberHistory

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
FamilyMemberHistory |  | 0..* | FamilyMemberHistory | Information about patient's relatives, relevant for patient
patient | S | 1..1 | Reference(QICorePatient) | Patient history is about
date | S | 0..1 | dateTime | When history was recorded or last updated
relationship | S | 1..1 | CodeableConcept | Relationship to the subject
age[x] | S | 0..1 | Age, Range, string | (approximate) age
deceased[x] | S | 0..1 | boolean, Age, Range, date, string | Dead? How old/when?
condition |  | 0..* | BackboneElement | Condition that the related person had
familymemberhistory-abatement |  | 0..1 | date, Age, boolean | When (or if) the family member's condition resolved URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
familymemberhistory-severity |  | 0..1 | CodeableConcept | The seriousness of the family member condition URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity Binding: Condition/DiagnosisSeverity (example): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S | 1..1 | CodeableConcept | Condition suffered by relation
onset[x] |  | 0..1 | Age, Range, Period, string | When condition first manifested
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
FamilyMemberHistory | I | 0..* | FamilyMemberHistory | Information about patient's relatives, relevant for patient
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
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: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
dataAbsentReason | Σ | 0..1 | CodeableConcept | subject-unknown | withheld | unable-to-obtain | deferred Binding: FamilyHistoryAbsentReason (example): Codes describing the reason why a family member's history is not available.
patient | S Σ | 1..1 | Reference(QICorePatient) | Patient history is about
date | S Σ | 0..1 | dateTime | When history was recorded or last updated
name | Σ | 0..1 | string | The family member described
relationship | S Σ | 1..1 | CodeableConcept | Relationship to the subject Binding: FamilyMember (example): The nature of the relationship between the patient and the related person being described in the family member history.
sex | Σ | 0..1 | CodeableConcept | male | female | other | unknown Binding: AdministrativeGender (extensible): Codes describing the sex assigned at birth as documented on the birth registration.
born[x] | I | 0..1 |  | (approximate) date of birth
bornPeriod |  |  | Period |
bornDate |  |  | date |
bornString |  |  | string |
age[x] | S Σ I | 0..1 |  | (approximate) age
ageAge |  |  | Age |
ageRange |  |  | Range |
ageString |  |  | string |
estimatedAge | Σ I | 0..1 | boolean | Age is estimated?
deceased[x] | S Σ | 0..1 |  | Dead? How old/when?
deceasedBoolean |  |  | boolean |
deceasedAge |  |  | Age |
deceasedRange |  |  | Range |
deceasedDate |  |  | date |
deceasedString |  |  | string |
reasonCode | Σ | 0..* | CodeableConcept | Why was family member history performed? Binding: SNOMEDCTClinicalFindings (example): Codes indicating why the family member history was done.
reasonReference | Σ | 0..* | Reference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference) | Why was family member history performed?
note |  | 0..* | Annotation | General note about related person
condition |  | 0..* | BackboneElement | Condition that the related person had
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
familymemberhistory-abatement |  | 0..1 | date, Age, boolean | When (or if) the family member's condition resolved URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-abatement
familymemberhistory-severity |  | 0..1 | CodeableConcept | The seriousness of the family member condition URL: http://hl7.org/fhir/StructureDefinition/familymemberhistory-severity Binding: Condition/DiagnosisSeverity (example): A subjective assessment of the severity of the condition as evaluated by the clinician.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | Condition suffered by relation Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
outcome |  | 0..1 | CodeableConcept | deceased | permanent disability | etc. Binding: ConditionOutcomeCodes (example): The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.
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
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
FamilyMemberHistory.language | preferred | CommonLanguages Max Binding: AllLanguages
FamilyMemberHistory.status | required | FamilyHistoryStatus
FamilyMemberHistory.dataAbsentReason | example | FamilyHistoryAbsentReason
FamilyMemberHistory.relationship | example | FamilyMember
FamilyMemberHistory.sex | extensible | AdministrativeGender
FamilyMemberHistory.reasonCode | example | SNOMEDCTClinicalFindings
FamilyMemberHistory.condition.code | example | Condition/Problem/DiagnosisCodes
FamilyMemberHistory.condition.outcome | example | ConditionOutcomeCodes

#### Constraints

Id | Grade | Path | Details | Requirements
dom-2 | error | FamilyMemberHistory | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | FamilyMemberHistory | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | FamilyMemberHistory | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | FamilyMemberHistory | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | Best Practice | FamilyMemberHistory | A resource should have narrative for robust management : text.`div`.exists() |
fhs-1 | error | FamilyMemberHistory | Can have age[x] or born[x], but not both : age.empty() or born.empty() |
fhs-2 | error | FamilyMemberHistory | Can only have estimatedAge if age[x] is present : age.exists() or estimatedAge.empty() |
ele-1 | error | FamilyMemberHistory.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.instantiatesCanonical | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.instantiatesUri | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.dataAbsentReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.patient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.date | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.name | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.relationship | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.sex | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.born[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.age[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.estimatedAge | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.deceased[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.reasonCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.reasonReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.condition.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.condition.extension:condition-abatement | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.condition.extension:condition-abatement | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.condition.extension:condition-severity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.condition.extension:condition-severity | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.condition.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | FamilyMemberHistory.condition.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | FamilyMemberHistory.condition.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition.outcome | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition.contributedToDeath | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition.onset[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | FamilyMemberHistory.condition.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |