MCC eCare Plan Implementation Guide
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MCC eCare Plan Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-mcc/ and changes regularly. See the Directory of published versions

Resource Profile: MCCFamilyHistory - Detailed Descriptions

Active as of 2024-05-16

Definitions for the MCCFamilyHistory resource profile.

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

0. FamilyMemberHistory
2. FamilyMemberHistory.extension
SlicingThis element introduces a set of slices on FamilyMemberHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. FamilyMemberHistory.extension:resource-pertainsToGoal
    Slice Nameresource-pertainsToGoal
    TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
    Must Supporttrue
    6. FamilyMemberHistory.relationship
    ShortFirst Degree Family Member
    BindingThe codes SHOULD be taken from First Degree Family Member .
    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92)

    This set of values includes first degree family members (i.e., parent, sibling, full child)

    LabelLabel
    8. FamilyMemberHistory.condition
    Control1..*
    Must Supporttrue
    10. FamilyMemberHistory.condition.code
    Must Supporttrue

    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.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    SlicingThis element introduces a set of slices on FamilyMemberHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. FamilyMemberHistory.extension:resource-pertainsToGoal
      Slice Nameresource-pertainsToGoal
      Definition

      Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

      ShortPertains to goal
      Comments

      This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

      Control0..*
      TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
      Is Modifierfalse
      Must Supporttrue
      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())
      8. 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())
      10. 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()))
      12. FamilyMemberHistory.patient
      Definition

      The person who this history concerns.

      ShortPatient history is about
      Control1..1
      TypeReference(Patient)
      Is Modifierfalse
      Summarytrue
      Alternate NamesProband
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. FamilyMemberHistory.relationship
      Definition

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

      ShortFirst Degree Family MemberRelationship to the subject
      Control1..1
      BindingThe codes SHOULD be taken from For example codes, see First Degree Family Member .http://terminology.hl7.org/ValueSet/v3-FamilyMember
      (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92)

      This set of values includes first degree family members (i.e., parent, sibling, full child)


      The nature of the relationship between the patient and the related person being described in the family member history.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      LabelLabel
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. 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
      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. 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())
      20. 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.

      ShortCondition suffered by relation
      Control1..1
      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
      (example to http://hl7.org/fhir/ValueSet/condition-code)

      Identification of the Condition or diagnosis.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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 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())
      2. FamilyMemberHistory.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical 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.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-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.

      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()))
      8. FamilyMemberHistory.language
      Definition

      The base language in which the resource is written.

      ShortLanguage 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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-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.

      ShortText 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.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-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.

      ShortContained, 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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. FamilyMemberHistory.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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())
      SlicingThis element introduces a set of slices on FamilyMemberHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. FamilyMemberHistory.extension:resource-pertainsToGoal
        Slice Nameresource-pertainsToGoal
        Definition

        Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

        ShortPertains to goal
        Comments

        This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

        Control0..*
        TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
        Is Modifierfalse
        Must Supporttrue
        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())
        18. 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())
        20. 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.

        ShortExternal 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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. 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.

        ShortInstantiates FHIR protocol or definition
        Control0..*
        Typecanonical(PlanDefinition, Questionnaire, ActivityDefinition, Measure, OperationDefinition)
        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()))
        24. 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.

        ShortInstantiates external protocol or definition
        Comments

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

        Control0..*
        Typeuri
        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()))
        26. 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 FamilyHistoryStatus
        (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()))
        28. FamilyMemberHistory.dataAbsentReason
        Definition

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

        Shortsubject-unknown | withheld | unable-to-obtain | deferred
        Control0..1
        BindingFor example codes, see FamilyHistoryAbsentReason
        (example to http://hl7.org/fhir/ValueSet/history-absent-reason)

        Codes describing the reason why a family member's history is not available.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

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

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

        The person who this history concerns.

        ShortPatient history is about
        Control1..1
        TypeReference(Patient)
        Is Modifierfalse
        Summarytrue
        Alternate NamesProband
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. FamilyMemberHistory.date
        Definition

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

        ShortWhen 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()))
        34. FamilyMemberHistory.name
        Definition

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

        ShortThe family member described
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

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

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

        ShortFirst Degree Family Member
        Control1..1
        BindingThe codes SHOULD be taken from First Degree Family Member .
        (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92)

        This set of values includes first degree family members (i.e., parent, sibling, full child)

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        LabelLabel
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. FamilyMemberHistory.sex
        Definition

        The birth sex of the family member.

        Shortmale | 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.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from AdministrativeGender
        (extensible to http://hl7.org/fhir/ValueSet/administrative-gender)

        Codes describing the sex assigned at birth as documented on the birth registration.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. FamilyMemberHistory.born[x]
        Definition

        The actual or approximate date of birth of the relative.

        Short(approximate) date of birth
        Control0..1
        This element is affected by the following invariants: fhs-1
        TypeChoice of: Period, date, string
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Allows calculation of the relative's age.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. 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.

        Control0..1
        This element is affected by the following invariants: fhs-1
        TypeChoice of: Age, Range, string
        [x] NoteSee Choice of Data Types for 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()))
        44. FamilyMemberHistory.estimatedAge
        Definition

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

        ShortAge 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.

        Control0..1
        This element is affected by the following invariants: fhs-2
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Clinicians often prefer to specify an estimaged age rather than an age range.

        Meaning if MissingIt is unknown whether the age is an estimate or not
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. 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.

        ShortDead? How old/when?
        Control0..1
        TypeChoice of: boolean, Age, Range, date, string
        [x] NoteSee Choice of Data Types for 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()))
        48. FamilyMemberHistory.reasonCode
        Definition

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

        ShortWhy was family member history performed?
        Comments

        Textual reasons can be captured using reasonCode.text.

        Control0..*
        BindingFor example codes, see SNOMEDCTClinicalFindings
        (example to http://hl7.org/fhir/ValueSet/clinical-findings)

        Codes indicating why the family member history was done.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. FamilyMemberHistory.reasonReference
        Definition

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

        ShortWhy was family member history performed?
        Control0..*
        TypeReference(Condition, Observation, AllergyIntolerance, QuestionnaireResponse, DiagnosticReport, DocumentReference)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. 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.

        ShortGeneral note about related person
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. 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
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. 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.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        58. FamilyMemberHistory.condition.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. 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.

        ShortAdditional 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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        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())
        60. 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())
        62. 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.

        ShortCondition suffered by relation
        Control1..1
        BindingFor example codes, see Condition/Problem/DiagnosisCodes
        (example to http://hl7.org/fhir/ValueSet/condition-code)

        Identification of the Condition or diagnosis.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. FamilyMemberHistory.condition.outcome
        Definition

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

        Shortdeceased | permanent disability | etc.
        Control0..1
        BindingFor example codes, see ConditionOutcomeCodes
        (example to http://hl7.org/fhir/ValueSet/condition-outcome)

        The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. 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.

        ShortWhether the condition contributed to the cause of death
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. 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] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        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()))
        70. FamilyMemberHistory.condition.note
        Definition

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

        ShortExtra information about condition
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))