HL7 Europe Hospital Discharge Report
0.0.1-ci - ci-build 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Resource Profile: FamilyMemberHistoryEuHdrObligation - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the familyMemberHistory-obl-eu-hdr 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.dataAbsentReason
Definition

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

ShortReason for missing datasubject-unknown | withheld | unable-to-obtain | deferred
Control0..1
BindingFor example codes, see FamilyHistoryAbsentReasonhttp://hl7.org/fhir/ValueSet/history-absent-reason
(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
Obligations
    ObligationsActor
    SHALL:handleHDRConsumer
    SHOULD:able-to-populateHDRCreator
    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()))
    10. FamilyMemberHistory.patient
    Definition

    The person who this history concerns.

    ShortPatient history is about
    Control1..1
    TypeReference(Patient (EU core), Patient)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:handleHDRConsumer
      SHALL:able-to-populateHDRCreator
      Summarytrue
      Alternate NamesProband
      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.).

      ShortRelationship to the subject.
      Control1..1
      BindingFor example codes, see FamilyMemberhttp://terminology.hl7.org/ValueSet/v3-FamilyMember
      (example to http://terminology.hl7.org/ValueSet/v3-FamilyMember)

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

      TypeCodeableConcept
      Is Modifierfalse
      Obligations
        ObligationsActor
        SHALL:handleHDRConsumer
        SHOULD:able-to-populateHDRCreator
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. 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] 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
        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()))
        SlicingThis element introduces a set of slices on FamilyMemberHistory.born[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 16. FamilyMemberHistory.born[x]:bornDate
          Slice NamebornDate
          Definition

          The actual or approximate date of birth of the relative.

          ShortDate of birth of the relative(approximate) date of birth
          Control0..1
          This element is affected by the following invariants: fhs-1
          Typedate, string, Period
          [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
          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()))
          18. 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] 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()))
          SlicingThis element introduces a set of slices on FamilyMemberHistory.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 20. FamilyMemberHistory.deceased[x]:deceasedAge
            Slice NamedeceasedAge
            Definition

            Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.

            Short(Approximate) age at death of the relativeDead? How old/when?
            Control0..1
            TypeAge, date, boolean, string, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:handleHDRConsumer
              MAY:able-to-populateHDRCreator
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. FamilyMemberHistory.deceased[x]:deceasedDate
              Slice NamedeceasedDate
              Definition

              Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.

              ShortDate of death of the relativeDead? How old/when?
              Control0..1
              Typedate, boolean, string, Range, Age
              [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
              Obligations
                ObligationsActor
                SHALL:handleHDRConsumer
                MAY:able-to-populateHDRCreator
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. 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
                Obligations
                  ObligationsActor
                  SHALL:handleHDRConsumer
                  SHOULD:able-to-populateHDRCreator
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  26. 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())
                  28. 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
                  BindingThe codes SHOULD be taken from For example codes, see Condition Value Sethttp://hl7.org/fhir/ValueSet/condition-code
                  (preferred to http://hl7.eu/fhir/hdr/ValueSet/condition-eu-hdr)
                  TypeCodeableConcept(Codeable Concept (IPS))
                  Is Modifierfalse
                  Obligations
                    ObligationsActor
                    SHALL:handleHDRConsumer
                    SHALL:able-to-populateHDRCreator
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. FamilyMemberHistory.condition.note
                    Definition

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

                    ShortExtra information about this conditionExtra information about condition
                    Control0..*
                    TypeAnnotation
                    Is Modifierfalse
                    Obligations
                      ObligationsActor
                      SHALL:handleHDRConsumer
                      MAY:able-to-populateHDRCreator
                      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
                      2. FamilyMemberHistory.dataAbsentReason
                      Obligations
                        ObligationsActor
                        SHALL:handleHDRConsumer
                        SHOULD:able-to-populateHDRCreator
                        4. FamilyMemberHistory.patient
                        Obligations
                          ObligationsActor
                          SHALL:handleHDRConsumer
                          SHALL:able-to-populateHDRCreator
                          6. FamilyMemberHistory.relationship
                          Obligations
                            ObligationsActor
                            SHALL:handleHDRConsumer
                            SHOULD:able-to-populateHDRCreator
                            8. FamilyMemberHistory.deceased[x]:deceasedAge
                            Slice NamedeceasedAge
                            TypeAge
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Obligations
                              ObligationsActor
                              SHALL:handleHDRConsumer
                              MAY:able-to-populateHDRCreator
                              10. FamilyMemberHistory.deceased[x]:deceasedDate
                              Slice NamedeceasedDate
                              Typedate
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Obligations
                                ObligationsActor
                                SHALL:handleHDRConsumer
                                MAY:able-to-populateHDRCreator
                                12. FamilyMemberHistory.condition
                                Obligations
                                  ObligationsActor
                                  SHALL:handleHDRConsumer
                                  SHOULD:able-to-populateHDRCreator
                                  14. FamilyMemberHistory.condition.code
                                  Obligations
                                    ObligationsActor
                                    SHALL:handleHDRConsumer
                                    SHALL:able-to-populateHDRCreator
                                    16. FamilyMemberHistory.condition.note
                                    Obligations
                                      ObligationsActor
                                      SHALL:handleHDRConsumer
                                      MAY:able-to-populateHDRCreator

                                      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

                                      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.

                                      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())
                                      16. FamilyMemberHistory.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      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())
                                      18. FamilyMemberHistory.identifier
                                      Definition

                                      Business identifiers assigned to this family member history by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                                      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()))
                                      20. FamilyMemberHistory.instantiatesCanonical
                                      Definition

                                      The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistory.

                                      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()))
                                      22. FamilyMemberHistory.instantiatesUri
                                      Definition

                                      The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistory.

                                      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()))
                                      24. 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()))
                                      26. FamilyMemberHistory.dataAbsentReason
                                      Definition

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

                                      ShortReason for missing data
                                      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
                                      Obligations
                                        ObligationsActor
                                        SHALL:handleHDRConsumer
                                        SHOULD:able-to-populateHDRCreator
                                        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()))
                                        28. FamilyMemberHistory.patient
                                        Definition

                                        The person who this history concerns.

                                        ShortPatient history is about
                                        Control1..1
                                        TypeReference(Patient (EU core))
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:handleHDRConsumer
                                          SHALL:able-to-populateHDRCreator
                                          Summarytrue
                                          Alternate NamesProband
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          30. FamilyMemberHistory.date
                                          Definition

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

                                          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()))
                                          32. 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()))
                                          34. FamilyMemberHistory.relationship
                                          Definition

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

                                          ShortRelationship to the subject.
                                          Control1..1
                                          BindingFor example codes, see FamilyMember
                                          (example to http://terminology.hl7.org/ValueSet/v3-FamilyMember)

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

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:handleHDRConsumer
                                            SHOULD:able-to-populateHDRCreator
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            36. FamilyMemberHistory.sex
                                            Definition

                                            The birth sex of the family member.

                                            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()))
                                            38. 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] 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
                                            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()))
                                            SlicingThis element introduces a set of slices on FamilyMemberHistory.born[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 40. FamilyMemberHistory.born[x]:bornDate
                                              Slice NamebornDate
                                              Definition

                                              The actual or approximate date of birth of the relative.

                                              ShortDate of birth of the relative
                                              Control0..1
                                              This element is affected by the following invariants: fhs-1
                                              Typedate
                                              [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
                                              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] 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()))
                                              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] 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()))
                                              SlicingThis element introduces a set of slices on FamilyMemberHistory.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 48. FamilyMemberHistory.deceased[x]:deceasedAge
                                                Slice NamedeceasedAge
                                                Definition

                                                Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.

                                                Short(Approximate) age at death of the relative
                                                Control0..1
                                                TypeAge
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handleHDRConsumer
                                                  MAY:able-to-populateHDRCreator
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  50. FamilyMemberHistory.deceased[x]:deceasedDate
                                                  Slice NamedeceasedDate
                                                  Definition

                                                  Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.

                                                  ShortDate of death of the relative
                                                  Control0..1
                                                  Typedate
                                                  [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
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handleHDRConsumer
                                                    MAY:able-to-populateHDRCreator
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    52. 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()))
                                                    54. 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()))
                                                    56. 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()))
                                                    58. 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
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handleHDRConsumer
                                                      SHOULD:able-to-populateHDRCreator
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      60. 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
                                                      62. 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())
                                                      64. 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())
                                                      66. 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
                                                      BindingThe codes SHOULD be taken from Condition Value Set
                                                      (preferred to http://hl7.eu/fhir/hdr/ValueSet/condition-eu-hdr)
                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      Is Modifierfalse
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handleHDRConsumer
                                                        SHALL:able-to-populateHDRCreator
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        68. 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()))
                                                        70. 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()))
                                                        72. 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
                                                        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()))
                                                        74. FamilyMemberHistory.condition.note
                                                        Definition

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

                                                        ShortExtra information about this condition
                                                        Control0..*
                                                        TypeAnnotation
                                                        Is Modifierfalse
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handleHDRConsumer
                                                          MAY:able-to-populateHDRCreator
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))