Example Usage Scenarios:

The following are example usage scenarios for the US Core FamilyMemberHistory profile:

• Query for a family member's relevant health history
• Record or update relevant health history for a a family member

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each FamilyMemberHistory Must Have:

1. a record status
2. a patient
3. a relationship to the patient

Each FamilyMemberHistory Must Support:

1. a condition that the related person had*

Additional USCDI Requirements:

These Additional USCDI Requirements elements are not Mandatory or Must Support but are required for ASTP Health IT certification testing and are included in the formal definition of the profile and the FamilyMemberHistory examples.

1. a recorder*

*see guidance below

Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

• *USCDI's applicable vocabulary standards for Family Health History are SNOMED CT and ICD-10-CM.
  • The US Core Condition Codes supports ICD-9-CM for historical purposes only. When using ICD codes, only non-header ICD-10-CM codes SHOULD be used.

• *The profile element US Core FamilyMemberHistory Recorder Extension communicates the individual level provenance author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

Changes since version 8.0.0:

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient Constraints: fhs-1, fhs-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
patient	SΣ	1..1	Reference(US Core Patient Profile)	Patient history is about
relationship	SΣ	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
condition	S	0..*	BackboneElement	Condition that the related person had
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.status	required	FamilyHistoryStatus http://hl7.org/fhir/ValueSet/history-status|4.0.1 From the FHIR Standard
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG

Constraints

Id	Grade	Path(s)	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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()

This structure is derived from FamilyMemberHistory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory		0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
status	S	1..1	code	partial | completed | entered-in-error | health-unknown
patient	S	1..1	Reference(US Core Patient Profile)	Patient history is about
relationship	S	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
condition	S	0..*	BackboneElement	Condition that the related person had
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient Constraints: fhs-1, fhs-2
id	Σ	0..1	id	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): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
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	?!SΣ	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	SΣ	1..1	Reference(US Core Patient Profile)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
name	Σ	0..1	string	The family member described
relationship	SΣ	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
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]	C	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	ΣC	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	ΣC	0..1	boolean	Age is estimated?
deceased[x]	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	S	0..*	BackboneElement	Condition that the related person had
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
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

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
FamilyMemberHistory.status	required	FamilyHistoryStatus http://hl7.org/fhir/ValueSet/history-status|4.0.1 From the FHIR Standard
FamilyMemberHistory.dataAbsentReason	example	FamilyHistoryAbsentReason http://hl7.org/fhir/ValueSet/history-absent-reason|4.0.1 From the FHIR Standard
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.sex	extensible	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 From the FHIR Standard
FamilyMemberHistory.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1 From the FHIR Standard
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG
FamilyMemberHistory.condition.outcome	example	ConditionOutcomeCodes http://hl7.org/fhir/ValueSet/condition-outcome|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient Constraints: fhs-1, fhs-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
patient	SΣ	1..1	Reference(US Core Patient Profile)	Patient history is about
relationship	SΣ	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
condition	S	0..*	BackboneElement	Condition that the related person had
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.status	required	FamilyHistoryStatus http://hl7.org/fhir/ValueSet/history-status|4.0.1 From the FHIR Standard
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG

Constraints

Id	Grade	Path(s)	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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()

Differential View

This structure is derived from FamilyMemberHistory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory		0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
status	S	1..1	code	partial | completed | entered-in-error | health-unknown
patient	S	1..1	Reference(US Core Patient Profile)	Patient history is about
relationship	S	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
condition	S	0..*	BackboneElement	Condition that the related person had
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient Constraints: fhs-1, fhs-2
id	Σ	0..1	id	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): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recorder		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | US Core RelatedPerson Profile)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder
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	?!SΣ	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	SΣ	1..1	Reference(US Core Patient Profile)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
name	Σ	0..1	string	The family member described
relationship	SΣ	1..1	CodeableConcept	Relationship to the subject Binding: Family Member Value (extensible): Characterization of the familial relationship between two people.
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]	C	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	ΣC	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	ΣC	0..1	boolean	Age is estimated?
deceased[x]	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	S	0..*	BackboneElement	Condition that the related person had
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Condition suffered by relation Binding: US Core Condition Codes (extensible): Value set to describe the actual problem experienced by the patient
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

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
FamilyMemberHistory.status	required	FamilyHistoryStatus http://hl7.org/fhir/ValueSet/history-status|4.0.1 From the FHIR Standard
FamilyMemberHistory.dataAbsentReason	example	FamilyHistoryAbsentReason http://hl7.org/fhir/ValueSet/history-absent-reason|4.0.1 From the FHIR Standard
FamilyMemberHistory.relationship	extensible	FamilyMemberValue http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579 From https://vsac.nlm.nih.gov
FamilyMemberHistory.sex	extensible	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 From the FHIR Standard
FamilyMemberHistory.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1 From the FHIR Standard
FamilyMemberHistory.condition.code	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code From this IG
FamilyMemberHistory.condition.outcome	example	ConditionOutcomeCodes http://hl7.org/fhir/ValueSet/condition-outcome|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.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()

This structure is derived from FamilyMemberHistory

Summary

Must-Support: 5 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder

Maturity: 3

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• See the Scopes Format section for a description of the SMART scopes syntax.
• See the Search Syntax section for a description of the US Core search syntax.
• See the General Requirements section for additional rules and expectations when a Server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to family health history data SHALL support these US Core SMART Scopes:

• resource level scopes: <patient|user|system>/FamilyMemberHistory.rs

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching for all family member’s relevant health history using the patient search parameter:

   GET [base]/FamilyMemberHistory?patient={Type/}[id]

   Example:

   1. GET [base]/FamilyMemberHistory?patient=1137192

   Implementation Notes: Fetches a bundle of all FamilyMemberHistory resources for the specified patient (how to search by reference)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and code search parameters:

   GET [base]/FamilyMemberHistory?patient={Type/}[id]&code={system|}[code]

   Example:

   1. GET [base]/FamilyMemberHistory?patient=1032702&code=[code]

   Implementation Notes: Fetches a bundle of all FamilyMemberHistory resources for the specified patient and condition (how to search by reference and how to search by token)