2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Resource Profile: USQualityCoreFamilyMemberHistory - Detailed Descriptions

Active as of 2026-05-15

Definitions for the us-quality-core-familymemberhistory resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. FamilyMemberHistory
Definition | Significant health conditions for a person related to the patient relevant in the context of care for the patient.
Short | Information about patient's relatives, relevant for patient
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) fhs-1: Can have age[x] or born[x], but not both (`age.empty() or born.empty()`) fhs-2: Can only have estimatedAge if age[x] is present (`age.exists() or estimatedAge.empty()`) fhs-1: Can have age[x] or born[x], but not both (age.empty() or born.empty()) fhs-2: Can only have estimatedAge if age[x] is present (age.exists() or estimatedAge.empty())
2. FamilyMemberHistory.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. FamilyMemberHistory.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. FamilyMemberHistory.status
Definition | A code specifying the status of the record of the family history of a specific family member.
Short | partial | completed | entered-in-error | health-unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from FamilyHistoryStatus http://hl7.org/fhir/ValueSet/history-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/history-status|4.0.1` ) A code that identifies the status of the family history record.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. FamilyMemberHistory.patient
Definition | The person who this history concerns.
Short | Patient history is about
Control | 1..1
Type | Reference(US Quality Core Patient, Patient)
Is Modifier | false
Summary | true
Alternate Names | Proband
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. FamilyMemberHistory.date
Definition | The date (and possibly time) when the family member history was recorded or last updated.
Short | When history was recorded or last updated
Comments | This should be captured even if the same as the date on the List aggregating the full family history.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows determination of how current the summary is.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. FamilyMemberHistory.relationship
Definition | The type of relationship this person has to the patient (father, mother, brother etc.).
Short | Relationship to the subject
Control | 1..1
Binding | The codes SHOULD be taken from For example codes, see V3 Value SetFamilyMember http://terminology.hl7.org/ValueSet/v3-FamilyMember (preferred to `http://terminology.hl7.org/ValueSet/v3-FamilyMember` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. FamilyMemberHistory.age[x]
Definition | The age of the relative at the time the family member history is recorded.
Short | (approximate) age
Comments | use estimatedAge to indicate whether the age is actual or not.
Control | 0..1 This element is affected by the following invariants: fhs-1
Type | Choice of: Age, Range, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. 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.
Short | Dead? How old/when?
Control | 0..1
Type | Choice of: boolean, Age, Range, date, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. 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.
Short | Condition that the related person had
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. FamilyMemberHistory.condition.extension:condition-abatement
Slice Name | condition-abatement
Definition | The approximate date, age, or flag indicating that the condition of the family member resolved. The abatement should only be specified if the condition is stated in the positive sense, i.e., the didNotHave flag is false.
Short | When (or if) the family member's condition resolved
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(FamilyMemberHistory Abatement) (Extension Type: Choice of: date, Age, boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. FamilyMemberHistory.condition.extension:condition-severity
Slice Name | condition-severity
Definition | A qualification of the seriousness or impact on health of the family member condition.
Short | The seriousness of the family member condition
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(FamilyMemberHistory Severity) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. FamilyMemberHistory.condition.modifierExtension
Definition | 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. 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.
Short | (USCDI+ Quality) Condition suffered by relationCondition suffered by relation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/condition-code` ) Identification of the Condition or diagnosis.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. 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.
Short | When condition first manifested
Control | 0..1
Type | Choice of: Age, Range, Period, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | Age of onset of a condition in relatives is predictive of risk for the patient.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. FamilyMemberHistory
2. FamilyMemberHistory.patient
Short | Patient history is about
Type | Reference(US Quality Core Patient)
4. FamilyMemberHistory.date
Short | When history was recorded or last updated
6. FamilyMemberHistory.relationship
Short | Relationship to the subject
Binding | The codes SHOULD be taken from V3 Value SetFamilyMember (preferred to `http://terminology.hl7.org/ValueSet/v3-FamilyMember` )
8. FamilyMemberHistory.age[x]
Short | (approximate) age
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
10. FamilyMemberHistory.deceased[x]
Short | Dead? How old/when?
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
12. FamilyMemberHistory.condition
Must Support | false
14. FamilyMemberHistory.condition.extension:condition-abatement
Slice Name | condition-abatement
Control | 0..1
Type | Extension(FamilyMemberHistory Abatement) (Extension Type: Choice of: date, Age, boolean)
Must Support | false
16. FamilyMemberHistory.condition.extension:condition-severity
Slice Name | condition-severity
Control | 0..1
Binding | The codes SHOULD be taken from Condition/DiagnosisSeverity (preferred to `http://hl7.org/fhir/ValueSet/condition-severity` ) Valueset to identify the severity of the problem
Type | Extension(FamilyMemberHistory Severity) (Extension Type: CodeableConcept)
Must Support | false
18. FamilyMemberHistory.condition.code
Short | (USCDI+ Quality) Condition suffered by relation
Binding | Unless not suitable, these codes SHALL be taken from Condition/Problem/DiagnosisCodes (extensible to `http://hl7.org/fhir/ValueSet/condition-code` ) Identification of the Condition or diagnosis.
20. FamilyMemberHistory.condition.onset[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | false

Guidance on how to interpret the contents of this table can be foundhere

0. FamilyMemberHistory
Definition | Significant health conditions for a person related to the patient relevant in the context of care for the patient.
Short | Information about patient's relatives, relevant for patient
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) fhs-1: Can have age[x] or born[x], but not both (`age.empty() or born.empty()`) fhs-2: Can only have estimatedAge if age[x] is present (`age.exists() or estimatedAge.empty()`)
2. FamilyMemberHistory.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. FamilyMemberHistory.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. FamilyMemberHistory.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. FamilyMemberHistory.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. FamilyMemberHistory.text
Definition | A human-readable narrative that contains a summary of the resource and can 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.
Short | Text summary of the resource, for human interpretation
Comments | 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 information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. FamilyMemberHistory.contained
Definition | 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.
Short | Contained, inline Resources
Comments | 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. FamilyMemberHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. FamilyMemberHistory.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. FamilyMemberHistory.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.
Short | External Id(s) for this record
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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. FamilyMemberHistory.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.
Short | Instantiates FHIR protocol or definition
Control | 0..*
Type | canonical(PlanDefinition, Questionnaire, ActivityDefinition, Measure, OperationDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. FamilyMemberHistory.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.
Short | Instantiates external protocol or definition
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Control | 0..*
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. FamilyMemberHistory.status
Definition | A code specifying the status of the record of the family history of a specific family member.
Short | partial | completed | entered-in-error | health-unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from FamilyHistoryStatus (required to `http://hl7.org/fhir/ValueSet/history-status|4.0.1` ) A code that identifies the status of the family history record.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. FamilyMemberHistory.dataAbsentReason
Definition | Describes why the family member's history is not available.
Short | subject-unknown | withheld | unable-to-obtain | deferred
Control | 0..1
Binding | For example codes, see FamilyHistoryAbsentReason (example to `http://hl7.org/fhir/ValueSet/history-absent-reason|4.0.1` ) Codes describing the reason why a family member's history is not available.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | This is a separate element to allow it to have a distinct binding from reasonCode.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. FamilyMemberHistory.patient
Definition | The person who this history concerns.
Short | Patient history is about
Control | 1..1
Type | Reference(US Quality Core Patient)
Is Modifier | false
Summary | true
Alternate Names | Proband
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. FamilyMemberHistory.date
Definition | The date (and possibly time) when the family member history was recorded or last updated.
Short | When history was recorded or last updated
Comments | This should be captured even if the same as the date on the List aggregating the full family history.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows determination of how current the summary is.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. FamilyMemberHistory.name
Definition | This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair".
Short | The family member described
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows greater ease in ensuring the same person is being talked about.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. FamilyMemberHistory.relationship
Definition | The type of relationship this person has to the patient (father, mother, brother etc.).
Short | Relationship to the subject
Control | 1..1
Binding | The codes SHOULD be taken from V3 Value SetFamilyMember (preferred to `http://terminology.hl7.org/ValueSet/v3-FamilyMember` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. FamilyMemberHistory.sex
Definition | The birth sex of the family member.
Short | male | female | other | unknown
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.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from AdministrativeGender (extensible to `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` ) Codes describing the sex assigned at birth as documented on the birth registration.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Not all relationship codes imply sex and the relative's sex can be relevant for risk assessments.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. FamilyMemberHistory.born[x]
Definition | The actual or approximate date of birth of the relative.
Short | (approximate) date of birth
Control | 0..1 This element is affected by the following invariants: fhs-1
Type | Choice of: Period, date, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Allows calculation of the relative's age.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. FamilyMemberHistory.age[x]
Definition | The age of the relative at the time the family member history is recorded.
Short | (approximate) age
Comments | use estimatedAge to indicate whether the age is actual or not.
Control | 0..1 This element is affected by the following invariants: fhs-1
Type | Choice of: Age, Range, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. FamilyMemberHistory.estimatedAge
Definition | If true, indicates that the age value specified is an estimated value.
Short | Age is estimated?
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.
Control | 0..1 This element is affected by the following invariants: fhs-2
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Clinicians often prefer to specify an estimaged age rather than an age range.
Meaning if Missing | It is unknown whether the age is an estimate or not
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. 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.
Short | Dead? How old/when?
Control | 0..1
Type | Choice of: boolean, Age, Range, date, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. FamilyMemberHistory.reasonCode
Definition | Describes why the family member history occurred in coded or textual form.
Short | Why was family member history performed?
Comments | Textual reasons can be captured using reasonCode.text.
Control | 0..*
Binding | For example codes, see SNOMEDCTClinicalFindings (example to `http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1` ) Codes indicating why the family member history was done.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. FamilyMemberHistory.reasonReference
Definition | Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.
Short | Why was family member history performed?
Control | 0..*
Type | Reference(Condition, Observation, AllergyIntolerance, QuestionnaireResponse, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. 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.
Short | General note about related person
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. 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.
Short | Condition that the related person had
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. FamilyMemberHistory.condition.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
56. FamilyMemberHistory.condition.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `FamilyMemberHistory.condition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
58. FamilyMemberHistory.condition.extension:condition-abatement
Slice Name | condition-abatement
Definition | The approximate date, age, or flag indicating that the condition of the family member resolved. The abatement should only be specified if the condition is stated in the positive sense, i.e., the didNotHave flag is false.
Short | When (or if) the family member's condition resolved
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(FamilyMemberHistory Abatement) (Extension Type: Choice of: date, Age, boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
60. FamilyMemberHistory.condition.extension:condition-severity
Slice Name | condition-severity
Definition | A qualification of the seriousness or impact on health of the family member condition.
Short | The seriousness of the family member condition
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(FamilyMemberHistory Severity) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
62. FamilyMemberHistory.condition.modifierExtension
Definition | 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
64. 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.
Short | (USCDI+ Quality) Condition suffered by relation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Condition/Problem/DiagnosisCodes (extensible to `http://hl7.org/fhir/ValueSet/condition-code` ) Identification of the Condition or diagnosis.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. FamilyMemberHistory.condition.outcome
Definition | Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation.
Short | deceased | permanent disability | etc.
Control | 0..1
Binding | For example codes, see ConditionOutcomeCodes (example to `http://hl7.org/fhir/ValueSet/condition-outcome|4.0.1` ) The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. FamilyMemberHistory.condition.contributedToDeath
Definition | This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.
Short | Whether the condition contributed to the cause of death
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. 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.
Short | When condition first manifested
Control | 0..1
Type | Choice of: Age, Range, Period, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | Age of onset of a condition in relatives is predictive of risk for the patient.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. FamilyMemberHistory.condition.note
Definition | An area where general notes can be placed about this specific condition.
Short | Extra information about condition
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)