QI-Core Implementation Guide
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QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICoreFamilyMemberHistory - Detailed Descriptions

Active as of 2018-08-22

Definitions for the qicore-familymemberhistory resource profile.

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

0. FamilyMemberHistory
Definition

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

ShortInformation about patient's relatives, relevant for patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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.

ShortA 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.

Control0..1
Typeuri
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-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).

ShortExtensions 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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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 Namesextensions, user content
Invariantsele-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.

Shortpartial | 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.

Control1..1
BindingThe codes SHALL be taken from FamilyHistoryStatushttp://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.

Typecode
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-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(QI) Patient history is aboutPatient history is about
Control1..1
TypeReference(QICore Patient, Patient)
Is Modifierfalse
Summarytrue
Alternate NamesProband
Invariantsele-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(QI) When history was recorded or last updatedWhen 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.

Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows determination of how current the summary is.

Invariantsele-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(QI) Relationship to the subjectRelationship to the subject
Control1..1
BindingThe codes SHOULD be taken from For example codes, see FamilyMemberhttp://terminology.hl7.org/ValueSet/v3-FamilyMember
(preferred to http://terminology.hl7.org/ValueSet/v3-FamilyMember)
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-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(QI) (approximate) age(approximate) age
Comments

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

Control0..1
This element is affected by the following invariants: fhs-1
TypeChoice of: Age, Range, string
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians.

Invariantsele-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(QI) Dead? How old/when?Dead? How old/when?
Control0..1
TypeChoice of: boolean, Age, Range, date, string
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-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.

ShortCondition that the related person had
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. FamilyMemberHistory.condition.extension:condition-abatement
Slice Namecondition-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.

ShortWhen (or if) the family member's condition resolved
Control0..1
TypeExtension(FamilyMemberHistory Abatement) (Extension Type: Choice of: date, Age, boolean)
Is Modifierfalse
Must Supportfalse
Invariantsele-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())
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())
22. FamilyMemberHistory.condition.extension:condition-severity
Slice Namecondition-severity
Definition

A qualification of the seriousness or impact on health of the family member condition.

ShortThe seriousness of the family member condition
Control0..1
TypeExtension(FamilyMemberHistory Severity) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supportfalse
Invariantsele-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())
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())
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).

ShortExtensions 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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
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 Namesextensions, user content, modifiers
Invariantsele-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(QI) Condition suffered by relationCondition suffered by relation
Control1..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
(extensible to http://hl7.org/fhir/ValueSet/condition-code)

Identification of the Condition or diagnosis.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-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.

ShortWhen condition first manifested
Control0..1
TypeChoice of: Age, Range, Period, string
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Requirements

Age of onset of a condition in relatives is predictive of risk for the patient.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))