Release 4 5 Snapshot #1

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). (v5.0.0-snapshot1: R5 Snapshot #1). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Patient Care Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Patient

Detailed Descriptions for the elements in the FamilyMemberHistory resource.

FamilyMemberHistory
Element Id FamilyMemberHistory
Definition

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

Cardinality 0..*
Type DomainResource
Summary false
Invariants
Defined on this element
fhs-1 Rule Can have age[x] or born[x], but not both age.empty() or born.empty()
fhs-2 Rule Can only have estimatedAge if age[x] is present age.exists() or estimatedAge.empty()
FamilyMemberHistory.identifier
Element Id 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.

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
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.

Summary true
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.

FamilyMemberHistory.instantiatesCanonical
Element Id 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.

Cardinality 0..*
Type canonical ( PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition )
Summary true
FamilyMemberHistory.instantiatesUri
Element Id 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.

Cardinality 0..*
Type uri
Summary true
Comments

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

FamilyMemberHistory.status
Element Id FamilyMemberHistory.status
Definition

A code specifying the status of the record of the family history of a specific family member.

Cardinality 1..1
Terminology Binding FamilyHistoryStatus ( Required )
Type code
Is Modifier true (Reason: 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)
Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

FamilyMemberHistory.dataAbsentReason
Element Id FamilyMemberHistory.dataAbsentReason
Definition

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

Cardinality 0..1
Terminology Binding FamilyHistoryAbsentReason ( Example )
Type CodeableConcept
Requirements

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

Summary true
FamilyMemberHistory.patient
Element Id FamilyMemberHistory.patient
Definition

The person who this history concerns.

Cardinality 1..1
Type Reference ( Patient )
Alternate Names Proband
Summary true
Comments

This is not the family member.

FamilyMemberHistory.date
Element Id FamilyMemberHistory.date
Definition

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

Cardinality 0..1
Type dateTime
Requirements

Allows determination of how current the summary is.

Summary true
Comments

This should be captured even if the same as the date on the List aggregating the full family history.

FamilyMemberHistory.name
Element Id FamilyMemberHistory.name
Definition

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

Cardinality 0..1
Type string
Requirements

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

Summary true
FamilyMemberHistory.relationship
Element Id FamilyMemberHistory.relationship
Definition

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

Cardinality 1..1
Terminology Binding V3 Value SetFamilyMember FamilyMember ( Example )
Type CodeableConcept
Summary true
FamilyMemberHistory.sex
Element Id FamilyMemberHistory.sex
Definition

The birth sex of the family member.

Cardinality 0..1
Terminology Binding AdministrativeGender ( Extensible )
Type CodeableConcept
Requirements

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

Summary true
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.

FamilyMemberHistory.born[x]
Element Id FamilyMemberHistory.born[x]
Definition

The actual or approximate date of birth of the relative.

Cardinality 0..1
Type Period | date | string
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

Allows calculation of the relative's age.

Summary false
Invariants
Affect this element
fhs-1 Rule Can have age[x] or born[x], but not both age.empty() or born.empty()
FamilyMemberHistory.age[x]
Element Id FamilyMemberHistory.age[x]
Definition

The age of the relative at the time the family member history is recorded.

Cardinality 0..1
Type Age | Range | string
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

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

Summary true
Comments

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

Invariants
Affect this element
fhs-1 Rule Can have age[x] or born[x], but not both age.empty() or born.empty()
FamilyMemberHistory.estimatedAge
Element Id FamilyMemberHistory.estimatedAge
Definition

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

Cardinality 0..1
Type boolean
Meaning if Missing It is unknown whether the age is an estimate or not
Requirements

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

Summary true
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.

Invariants
Affect this element
fhs-2 Rule Can only have estimatedAge if age[x] is present age.exists() or estimatedAge.empty()
FamilyMemberHistory.deceased[x]
Element Id 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.

Cardinality 0..1
Type boolean | Age | Range | date | string
[x] Note See Choice of Data Types for further information about how to use [x]
Summary true
FamilyMemberHistory.reasonCode FamilyMemberHistory.reason
Element Id FamilyMemberHistory.reasonCode FamilyMemberHistory.reason
Definition

Describes why the family member history occurred in coded or textual form. form, or Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.

Cardinality 0..*
Terminology Binding SNOMED CT Clinical Findings ( Example )
Type CodeableConcept Summary true Comments Textual reasons can be captured using reasonCode.text. FamilyMemberHistory.reasonReference Element Id FamilyMemberHistory.reasonReference Definition Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event. Cardinality 0..* Type Reference CodeableReference ( Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference )
Patterns CodeableReference(Condition,Observation,AllergyIntolerance,QuestionnaireResponse,DiagnosticReport,DocumentReference): No common pattern
Summary true
Comments

Textual reasons can be captured using reasonCode.text.

FamilyMemberHistory.note
Element Id 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.

Cardinality 0..*
Type Annotation
Summary false
FamilyMemberHistory.condition
Element Id 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.

Cardinality 0..*
Summary false
FamilyMemberHistory.condition.code
Element Id 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.

Cardinality 1..1
Terminology Binding Condition/Problem/Diagnosis Codes ( Example )
Type CodeableConcept
Summary false
FamilyMemberHistory.condition.outcome
Element Id FamilyMemberHistory.condition.outcome
Definition

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

Cardinality 0..1
Terminology Binding Condition Outcome Codes ( Example )
Type CodeableConcept
Summary false
FamilyMemberHistory.condition.contributedToDeath
Element Id 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.

Cardinality 0..1
Type boolean
Summary false
FamilyMemberHistory.condition.onset[x]
Element Id 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.

Cardinality 0..1
Type Age | Range | Period | string
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

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

Summary false
FamilyMemberHistory.condition.note
Element Id FamilyMemberHistory.condition.note
Definition

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

Cardinality 0..*
Type Annotation
Summary false
FamilyMemberHistory.procedure
Element Id FamilyMemberHistory.procedure
Definition

The significant Procedures (or procedure) that the family member had. This is a repeating section to allow a system to represent more than one procedure per resource, though there is nothing stopping multiple resources - one per procedure.

Cardinality 0..*
Summary false
FamilyMemberHistory.procedure.code
Element Id FamilyMemberHistory.procedure.code
Definition

The actual procedure specified. Could be a coded procedure or a less specific string depending on how much is known about the procedure and the capabilities of the creating system.

Cardinality 1..1
Terminology Binding Procedure Codes (SNOMED CT) ( Example )
Type CodeableConcept
Summary false
FamilyMemberHistory.procedure.outcome
Element Id FamilyMemberHistory.procedure.outcome
Definition

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

Cardinality 0..1
Terminology Binding SNOMED CT Clinical Findings ( Example )
Type CodeableConcept
Summary false
FamilyMemberHistory.procedure.contributedToDeath
Element Id FamilyMemberHistory.procedure.contributedToDeath
Definition

This procedure contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.

Cardinality 0..1
Type boolean
Summary false
FamilyMemberHistory.procedure.performed[x]
Element Id FamilyMemberHistory.procedure.performed[x]
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Cardinality 0..1
Type Age | Range | Period | string | dateTime
[x] Note See Choice of Data Types for further information about how to use [x]
Summary false
FamilyMemberHistory.procedure.note
Element Id FamilyMemberHistory.procedure.note
Definition

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

Cardinality 0..*
Type Annotation
Summary false