This profile provides a way for the Multiple Chronic Condition Care Plan to record, search, and fetch first degree family members and their chronic conditions, health concerns or any pertinent condition. The profile is based onthe FHIR Family Member History Resource This derived profile is designed to add requirements to the following elements:

• FamilyMemberHistory.condition is set to “Must Support”
• FamilyMemberHistory.relationship is bound to a first degree family member value set which is a subset of the V3 Family Member Value set. (“Required” in base resource)
• FamilyMemberHistory.extension:resource-pertainsToGoal (Must Support) to encourage linking a goal to the family history observation in hopes to facilitate and/or to encourage systems to be able to receive and understand a goal linkage if present.

Comments are welcome with respect to the pragmatic use of the “Must Support” rules defined on these elements.

No additional value sets were defined for use in this profile beyond the US Core Family Member History profile.

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

This structure is derived from FamilyMemberHistory

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory		0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
relationship		1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
condition	S	1..*	BackboneElement	Condition that the related person had
code	S	1..1	CodeableConcept	Condition suffered by relation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
FamilyMemberHistory.relationship	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient fhs-1: Can have age[x] or born[x], but not both fhs-2: Can only have estimatedAge if age[x] is present
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
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
patient	Σ	1..1	Reference(Patient)	Patient history is about
relationship	Σ	1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
condition	S	1..*	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: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
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	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code 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()

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient fhs-1: Can have age[x] or born[x], but not both fhs-2: Can only have estimatedAge if age[x] is present
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown | withheld | unable-to-obtain | deferred Binding: FamilyHistoryAbsentReason (example): Codes describing the reason why a family member's history is not available.
patient	Σ	1..1	Reference(Patient)	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	Σ	1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
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	1..*	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: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
outcome		0..1	CodeableConcept	deceased | permanent disability | etc. Binding: ConditionOutcomeCodes (example): The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.
contributedToDeath		0..1	boolean	Whether the condition contributed to the cause of death
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
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 from the FHIR Standard
FamilyMemberHistory.relationship	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov
FamilyMemberHistory.sex	extensible	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender from the FHIR Standard
FamilyMemberHistory.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
FamilyMemberHistory.condition.code	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
FamilyMemberHistory.condition.outcome	example	ConditionOutcomeCodes http://hl7.org/fhir/ValueSet/condition-outcome 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()

Differential View

This structure is derived from FamilyMemberHistory

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory		0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
relationship		1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
condition	S	1..*	BackboneElement	Condition that the related person had
code	S	1..1	CodeableConcept	Condition suffered by relation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
FamilyMemberHistory.relationship	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient fhs-1: Can have age[x] or born[x], but not both fhs-2: Can only have estimatedAge if age[x] is present
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
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
patient	Σ	1..1	Reference(Patient)	Patient history is about
relationship	Σ	1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
condition	S	1..*	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: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
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	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov
FamilyMemberHistory.condition.code	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code 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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	C	0..*	FamilyMemberHistory	Information about patient's relatives, relevant for patient fhs-1: Can have age[x] or born[x], but not both fhs-2: Can only have estimatedAge if age[x] is present
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	Pertains to goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?!Σ	1..1	code	partial | completed | entered-in-error | health-unknown Binding: FamilyHistoryStatus (required): A code that identifies the status of the family history record.
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown | withheld | unable-to-obtain | deferred Binding: FamilyHistoryAbsentReason (example): Codes describing the reason why a family member's history is not available.
patient	Σ	1..1	Reference(Patient)	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	Σ	1..1	CodeableConcept	First Degree Family Member Binding: First Degree Family Member (preferred): This set of values includes first degree family members (i.e., parent, sibling, full child)
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	1..*	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: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
outcome		0..1	CodeableConcept	deceased | permanent disability | etc. Binding: ConditionOutcomeCodes (example): The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.
contributedToDeath		0..1	boolean	Whether the condition contributed to the cause of death
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
FamilyMemberHistory.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
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 from the FHIR Standard
FamilyMemberHistory.relationship	preferred	FirstDegreeFamilyMember http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.92 from https://vsac.nlm.nih.gov
FamilyMemberHistory.sex	extensible	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender from the FHIR Standard
FamilyMemberHistory.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
FamilyMemberHistory.condition.code	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
FamilyMemberHistory.condition.outcome	example	ConditionOutcomeCodes http://hl7.org/fhir/ValueSet/condition-outcome 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

Mandatory: 1 element
Must-Support: 3 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal