Release 4 4B

This page is part of the FHIR Specification (v4.0.1: R4 (v4.3.0: R4B - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). ). 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 R4B R4 R3 R2

9.4 Resource FamilyMemberHistory - Content

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

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

9.4.1 Scope and Usage

FamilyMemberHistory is one of the event resources in the FHIR workflow specification.

This resource records significant health conditions for a particular individual related to the subject. This information can be known to different levels of accuracy. Sometimes the exact condition ('asthma') is known, and sometimes it is less precise ('some sort of cancer'). Equally, sometimes the person can be identified ('my aunt Agatha') and sometimes all that is known is that the person was an uncle.

This resource represents a simple structure used to capture an 'elementary' family history for a particular family member. However, it can also be the basis for capturing a more rigorous history useful for genetic and other analysis - refer to the Genetic Pedigree profile for an example.

The entire family history for an individual can be represented by combining references to FamilyMemberHistory instances into a List resource instance.

9.4.2 References

This resource is referenced by AdverseEvent and ClinicalImpression .

This resource implements the Event pattern.

9.4.2 9.4.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . FamilyMemberHistory I TU DomainResource Information about patient's relatives, relevant for patient
+ Rule: Can have age[x] or born[x], but not both
+ Rule: Can only have estimatedAge if age[x] is present
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . 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
. . . dataAbsentReason Σ 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred
FamilyHistoryAbsentReason ( Example )
. . . 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 Relationship to the subject
V3 Value SetFamilyMember FamilyMember ( Example )
. . . sex Σ 0..1 CodeableConcept male | female | other | unknown
AdministrativeGender ( Extensible )
. . . born[x] I 0..1 (approximate) date of birth
. . . . bornPeriod Period
. . . . bornDate date
. . . . bornString string
. . . age[x] Σ I 0..1 (approximate) age
. . . . ageAge Age
. . . . ageRange Range
. . . . ageString string
. . . estimatedAge Σ I 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?
SNOMED CT Clinical Findings ( Example )
. . . 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 0..* BackboneElement Condition that the related person had
. . . . code 1..1 CodeableConcept Condition suffered by relation
Condition/Problem/Diagnosis Codes ( Example )
. . . . outcome 0..1 CodeableConcept deceased | permanent disability | etc.
Condition Outcome Codes ( Example )
. . . . 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

doco Documentation for this format

UML Diagram ( Legend )

FamilyMemberHistory ( DomainResource ) 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 identifier : Identifier [0..*] 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 instantiatesCanonical : canonical [0..*] « PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition » 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 instantiatesUri : uri [0..*] A code specifying the status of the record of the family history of a specific family member (this element modifies the meaning of other elements) status : code [1..1] « A code that identifies the status of the family history record. null (Strength=Required) FamilyHistoryStatus ! » Describes why the family member's history is not available dataAbsentReason : CodeableConcept [0..1] « Codes describing the reason why a family member's history is not available. null (Strength=Example) FamilyHistoryAbsentReason ?? » The person who this history concerns patient : Reference [1..1] « Patient » The date (and possibly time) when the family member history was recorded or last updated date : dateTime [0..1] This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair" name : string [0..1] The type of relationship this person has to the patient (father, mother, brother etc.) relationship : CodeableConcept [1..1] « The nature of the relationship between the patient and the related person being described in the family member history. null (Strength=Example) v3.FamilyMember FamilyMember ?? » The birth sex of the family member sex : CodeableConcept [0..1] « Codes describing the sex assigned at birth as documented on the birth registration. null (Strength=Extensible) AdministrativeGender + » The actual or approximate date of birth of the relative born[x] : Type Element [0..1] « Period | date | string » The age of the relative at the time the family member history is recorded age[x] : Type Element [0..1] « Age | Range | string » If true, indicates that the age value specified is an estimated value estimatedAge : boolean [0..1] Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record deceased[x] : Type Element [0..1] « boolean | Age | Range | date | string » Describes why the family member history occurred in coded or textual form reasonCode : CodeableConcept [0..*] « Codes indicating why the family member history was done. null (Strength=Example) SNOMEDCTClinicalFindings ?? » Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event reasonReference : Reference [0..*] « Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference » 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 note : Annotation [0..*] Condition 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 code : CodeableConcept [1..1] « Identification of the Condition or diagnosis. null (Strength=Example) Condition/Problem/DiagnosisCo... ?? » Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation outcome : CodeableConcept [0..1] « The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. null (Strength=Example) ConditionOutcomeCodes ?? » This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown contributedToDeath : boolean [0..1] 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 onset[x] : Type Element [0..1] « Age | Range | Period | string » An area where general notes can be placed about this specific condition note : Annotation [0..*] 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 condition [0..*]

XML Template 

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <|
   </instantiatesCanonical>

 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <dataAbsentReason><!-- 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred --></dataAbsentReason>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was recorded or last updated -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <</relationship>

 <relationship><!-- 1..1 CodeableConcept Relationship to the subject  --></relationship>

 <sex><!-- 0..1 CodeableConcept male | female | other | unknown --></sex>
 <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- ?? 0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!-- ?? 0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reasonCode><!-- 0..* CodeableConcept Why was family member history performed? --></reasonCode>
 <|
   </reasonReference>

 <reasonReference><!-- 0..* Reference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) Why was family member history performed? --></reasonReference>
 <note><!-- 0..* Annotation General note about related person --></note>
 <condition>  <!-- 0..* Condition that the related person had -->
  <code><!-- 1..1 CodeableConcept Condition suffered by relation --></code>
  <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the condition contributed to the cause of death -->
  <onset[x]><!-- 0..1 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template 

{doco
  "resourceType" : "FamilyMemberHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "|
   

  "instantiatesCanonical" : [{ canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "dataAbsentReason" : { CodeableConcept }, // subject-unknown | withheld | unable-to-obtain | deferred
  "patient" : { Reference(Patient) }, // R!  Patient history is about
  "date" : "<dateTime>", // When history was recorded or last updated
  "name" : "<string>", // The family member described
  "

  "relationship" : { CodeableConcept }, // R!  Relationship to the subject 

  "sex" : { CodeableConcept }, // male | female | other | unknown
  // born[x]: (approximate) date of birth. One of these 3:
  "bornPeriod" : { Period },
  "bornDate" : "<date>",
  "bornString" : "<string>",
  // age[x]: (approximate) age. One of these 3:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // C? Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reasonCode" : [{ CodeableConcept }], // Why was family member history performed?
  "|
   

  "reasonReference" : [{ Reference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) }], // Why was family member history performed?
  "note" : [{ Annotation }], // General note about related person
  "condition" : [{ // Condition that the related person had
    "code" : { CodeableConcept }, // R!  Condition suffered by relation
    "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
    "contributedToDeath" : <boolean>, // Whether the condition contributed to the cause of death
    // onset[x]: When condition first manifested. One of these 4:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:FamilyMemberHistory;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:FamilyMemberHistory.identifier [ Identifier ], ... ; # 0..* External Id(s) for this record
  fhir:

  fhir:FamilyMemberHistory.instantiatesCanonical [ canonical(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ], ... ; # 0..* Instantiates FHIR protocol or definition

  fhir:FamilyMemberHistory.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:FamilyMemberHistory.status [ code ]; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:FamilyMemberHistory.dataAbsentReason [ CodeableConcept ]; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:FamilyMemberHistory.patient [ Reference(Patient) ]; # 1..1 Patient history is about
  fhir:FamilyMemberHistory.date [ dateTime ]; # 0..1 When history was recorded or last updated
  fhir:FamilyMemberHistory.name [ string ]; # 0..1 The family member described
  fhir:FamilyMemberHistory.relationship [ CodeableConcept ]; # 1..1 Relationship to the subject
  fhir:FamilyMemberHistory.sex [ CodeableConcept ]; # 0..1 male | female | other | unknown
  # FamilyMemberHistory.born[x] : 0..1 (approximate) date of birth. One of these 3
    fhir:FamilyMemberHistory.bornPeriod [ Period ]
    fhir:FamilyMemberHistory.bornDate [ date ]
    fhir:FamilyMemberHistory.bornString [ string ]
  # FamilyMemberHistory.age[x] : 0..1 (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 Age is estimated?
  # FamilyMemberHistory.deceased[x] : 0..1 Dead? How old/when?. One of these 5
    fhir:FamilyMemberHistory.deceasedBoolean [ boolean ]
    fhir:FamilyMemberHistory.deceasedAge [ Age ]
    fhir:FamilyMemberHistory.deceasedRange [ Range ]
    fhir:FamilyMemberHistory.deceasedDate [ date ]
    fhir:FamilyMemberHistory.deceasedString [ string ]
  fhir:FamilyMemberHistory.reasonCode [ CodeableConcept ], ... ; # 0..* Why was family member history performed?
  fhir:|
  

  fhir:FamilyMemberHistory.reasonReference [ Reference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.note [ Annotation ], ... ; # 0..* General note about related person
  fhir:FamilyMemberHistory.condition [ # 0..* Condition that the related person had
    fhir:FamilyMemberHistory.condition.code [ CodeableConcept ]; # 1..1 Condition suffered by relation
    fhir:FamilyMemberHistory.condition.outcome [ CodeableConcept ]; # 0..1 deceased | permanent disability | etc.
    fhir:FamilyMemberHistory.condition.contributedToDeath [ boolean ]; # 0..1 Whether the condition contributed to the cause of death
    # FamilyMemberHistory.condition.onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:FamilyMemberHistory.condition.onsetAge [ Age ]
      fhir:FamilyMemberHistory.condition.onsetRange [ Range ]
      fhir:FamilyMemberHistory.condition.onsetPeriod [ Period ]
      fhir:FamilyMemberHistory.condition.onsetString [ string ]
    fhir:FamilyMemberHistory.condition.note [ Annotation ], ... ; # 0..* Extra information about condition
  ], ...;
]

Changes since R3 R4

FamilyMemberHistory.instantiatesCanonical Added Element FamilyMemberHistory.instantiatesUri Added Element
FamilyMemberHistory
FamilyMemberHistory.status FamilyMemberHistory.sex
  • Change value set from http://hl7.org/fhir/ValueSet/history-status http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/history-status|4.0.1 FamilyMemberHistory.dataAbsentReason Added Element FamilyMemberHistory.sex Added Element FamilyMemberHistory.estimatedAge No longer marked as Modifier FamilyMemberHistory.reasonReference Type Reference: Added Target Types DiagnosticReport, DocumentReference FamilyMemberHistory.condition.contributedToDeath Added Element FamilyMemberHistory.definition deleted FamilyMemberHistory.notDone deleted FamilyMemberHistory.notDoneReason deleted FamilyMemberHistory.gender deleted http://hl7.org/fhir/ValueSet/administrative-gender

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . FamilyMemberHistory I TU DomainResource Information about patient's relatives, relevant for patient
+ Rule: Can have age[x] or born[x], but not both
+ Rule: Can only have estimatedAge if age[x] is present
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . 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
. . . dataAbsentReason Σ 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred
FamilyHistoryAbsentReason ( Example )
. . . 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 Relationship to the subject
V3 Value SetFamilyMember FamilyMember ( Example )
. . . sex Σ 0..1 CodeableConcept male | female | other | unknown
AdministrativeGender ( Extensible )
. . . born[x] I 0..1 (approximate) date of birth
. . . . bornPeriod Period
. . . . bornDate date
. . . . bornString string
. . . age[x] Σ I 0..1 (approximate) age
. . . . ageAge Age
. . . . ageRange Range
. . . . ageString string
. . . estimatedAge Σ I 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?
SNOMED CT Clinical Findings ( Example )
. . . 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 0..* BackboneElement Condition that the related person had
. . . . code 1..1 CodeableConcept Condition suffered by relation
Condition/Problem/Diagnosis Codes ( Example )
. . . . outcome 0..1 CodeableConcept deceased | permanent disability | etc.
Condition Outcome Codes ( Example )
. . . . 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

doco Documentation for this format

UML Diagram ( Legend )

FamilyMemberHistory ( DomainResource ) 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 identifier : Identifier [0..*] 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 instantiatesCanonical : canonical [0..*] « PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition » 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 instantiatesUri : uri [0..*] A code specifying the status of the record of the family history of a specific family member (this element modifies the meaning of other elements) status : code [1..1] « A code that identifies the status of the family history record. null (Strength=Required) FamilyHistoryStatus ! » Describes why the family member's history is not available dataAbsentReason : CodeableConcept [0..1] « Codes describing the reason why a family member's history is not available. null (Strength=Example) FamilyHistoryAbsentReason ?? » The person who this history concerns patient : Reference [1..1] « Patient » The date (and possibly time) when the family member history was recorded or last updated date : dateTime [0..1] This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair" name : string [0..1] The type of relationship this person has to the patient (father, mother, brother etc.) relationship : CodeableConcept [1..1] « The nature of the relationship between the patient and the related person being described in the family member history. null (Strength=Example) v3.FamilyMember FamilyMember ?? » The birth sex of the family member sex : CodeableConcept [0..1] « Codes describing the sex assigned at birth as documented on the birth registration. null (Strength=Extensible) AdministrativeGender + » The actual or approximate date of birth of the relative born[x] : Type Element [0..1] « Period | date | string » The age of the relative at the time the family member history is recorded age[x] : Type Element [0..1] « Age | Range | string » If true, indicates that the age value specified is an estimated value estimatedAge : boolean [0..1] Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record deceased[x] : Type Element [0..1] « boolean | Age | Range | date | string » Describes why the family member history occurred in coded or textual form reasonCode : CodeableConcept [0..*] « Codes indicating why the family member history was done. null (Strength=Example) SNOMEDCTClinicalFindings ?? » Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event reasonReference : Reference [0..*] « Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference » 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 note : Annotation [0..*] Condition 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 code : CodeableConcept [1..1] « Identification of the Condition or diagnosis. null (Strength=Example) Condition/Problem/DiagnosisCo... ?? » Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation outcome : CodeableConcept [0..1] « The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. null (Strength=Example) ConditionOutcomeCodes ?? » This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown contributedToDeath : boolean [0..1] 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 onset[x] : Type Element [0..1] « Age | Range | Period | string » An area where general notes can be placed about this specific condition note : Annotation [0..*] 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 condition [0..*]

XML Template 

<FamilyMemberHistory xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Id(s) for this record --></identifier>
 <|
   </instantiatesCanonical>

 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <status value="[code]"/><!-- 1..1 partial | completed | entered-in-error | health-unknown -->
 <dataAbsentReason><!-- 0..1 CodeableConcept subject-unknown | withheld | unable-to-obtain | deferred --></dataAbsentReason>
 <patient><!-- 1..1 Reference(Patient) Patient history is about --></patient>
 <date value="[dateTime]"/><!-- 0..1 When history was recorded or last updated -->
 <name value="[string]"/><!-- 0..1 The family member described -->
 <</relationship>

 <relationship><!-- 1..1 CodeableConcept Relationship to the subject  --></relationship>

 <sex><!-- 0..1 CodeableConcept male | female | other | unknown --></sex>
 <born[x]><!-- ?? 0..1 Period|date|string (approximate) date of birth --></born[x]>
 <age[x]><!-- ?? 0..1 Age|Range|string (approximate) age --></age[x]>
 <estimatedAge value="[boolean]"/><!-- ?? 0..1 Age is estimated? -->
 <deceased[x]><!-- 0..1 boolean|Age|Range|date|string Dead? How old/when? --></deceased[x]>
 <reasonCode><!-- 0..* CodeableConcept Why was family member history performed? --></reasonCode>
 <|
   </reasonReference>

 <reasonReference><!-- 0..* Reference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) Why was family member history performed? --></reasonReference>
 <note><!-- 0..* Annotation General note about related person --></note>
 <condition>  <!-- 0..* Condition that the related person had -->
  <code><!-- 1..1 CodeableConcept Condition suffered by relation --></code>
  <outcome><!-- 0..1 CodeableConcept deceased | permanent disability | etc. --></outcome>
  <contributedToDeath value="[boolean]"/><!-- 0..1 Whether the condition contributed to the cause of death -->
  <onset[x]><!-- 0..1 Age|Range|Period|string When condition first manifested --></onset[x]>
  <note><!-- 0..* Annotation Extra information about condition --></note>
 </condition>
</FamilyMemberHistory>

JSON Template 

{doco
  "resourceType" : "FamilyMemberHistory",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Id(s) for this record
  "|
   

  "instantiatesCanonical" : [{ canonical(ActivityDefinition|Measure|
   OperationDefinition|PlanDefinition|Questionnaire) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "status" : "<code>", // R!  partial | completed | entered-in-error | health-unknown
  "dataAbsentReason" : { CodeableConcept }, // subject-unknown | withheld | unable-to-obtain | deferred
  "patient" : { Reference(Patient) }, // R!  Patient history is about
  "date" : "<dateTime>", // When history was recorded or last updated
  "name" : "<string>", // The family member described
  "

  "relationship" : { CodeableConcept }, // R!  Relationship to the subject 

  "sex" : { CodeableConcept }, // male | female | other | unknown
  // born[x]: (approximate) date of birth. One of these 3:
  "bornPeriod" : { Period },
  "bornDate" : "<date>",
  "bornString" : "<string>",
  // age[x]: (approximate) age. One of these 3:
  "ageAge" : { Age },
  "ageRange" : { Range },
  "ageString" : "<string>",
  "estimatedAge" : <boolean>, // C? Age is estimated?
  // deceased[x]: Dead? How old/when?. One of these 5:
  "deceasedBoolean" : <boolean>,
  "deceasedAge" : { Age },
  "deceasedRange" : { Range },
  "deceasedDate" : "<date>",
  "deceasedString" : "<string>",
  "reasonCode" : [{ CodeableConcept }], // Why was family member history performed?
  "|
   

  "reasonReference" : [{ Reference(AllergyIntolerance|Condition|
   DiagnosticReport|DocumentReference|Observation|QuestionnaireResponse) }], // Why was family member history performed?
  "note" : [{ Annotation }], // General note about related person
  "condition" : [{ // Condition that the related person had
    "code" : { CodeableConcept }, // R!  Condition suffered by relation
    "outcome" : { CodeableConcept }, // deceased | permanent disability | etc.
    "contributedToDeath" : <boolean>, // Whether the condition contributed to the cause of death
    // onset[x]: When condition first manifested. One of these 4:
    "onsetAge" : { Age },
    "onsetRange" : { Range },
    "onsetPeriod" : { Period },
    "onsetString" : "<string>",
    "note" : [{ Annotation }] // Extra information about condition
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:FamilyMemberHistory;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:FamilyMemberHistory.identifier [ Identifier ], ... ; # 0..* External Id(s) for this record
  fhir:

  fhir:FamilyMemberHistory.instantiatesCanonical [ canonical(ActivityDefinition|Measure|OperationDefinition|PlanDefinition|Questionnaire) ], ... ; # 0..* Instantiates FHIR protocol or definition

  fhir:FamilyMemberHistory.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:FamilyMemberHistory.status [ code ]; # 1..1 partial | completed | entered-in-error | health-unknown
  fhir:FamilyMemberHistory.dataAbsentReason [ CodeableConcept ]; # 0..1 subject-unknown | withheld | unable-to-obtain | deferred
  fhir:FamilyMemberHistory.patient [ Reference(Patient) ]; # 1..1 Patient history is about
  fhir:FamilyMemberHistory.date [ dateTime ]; # 0..1 When history was recorded or last updated
  fhir:FamilyMemberHistory.name [ string ]; # 0..1 The family member described
  fhir:FamilyMemberHistory.relationship [ CodeableConcept ]; # 1..1 Relationship to the subject
  fhir:FamilyMemberHistory.sex [ CodeableConcept ]; # 0..1 male | female | other | unknown
  # FamilyMemberHistory.born[x] : 0..1 (approximate) date of birth. One of these 3
    fhir:FamilyMemberHistory.bornPeriod [ Period ]
    fhir:FamilyMemberHistory.bornDate [ date ]
    fhir:FamilyMemberHistory.bornString [ string ]
  # FamilyMemberHistory.age[x] : 0..1 (approximate) age. One of these 3
    fhir:FamilyMemberHistory.ageAge [ Age ]
    fhir:FamilyMemberHistory.ageRange [ Range ]
    fhir:FamilyMemberHistory.ageString [ string ]
  fhir:FamilyMemberHistory.estimatedAge [ boolean ]; # 0..1 Age is estimated?
  # FamilyMemberHistory.deceased[x] : 0..1 Dead? How old/when?. One of these 5
    fhir:FamilyMemberHistory.deceasedBoolean [ boolean ]
    fhir:FamilyMemberHistory.deceasedAge [ Age ]
    fhir:FamilyMemberHistory.deceasedRange [ Range ]
    fhir:FamilyMemberHistory.deceasedDate [ date ]
    fhir:FamilyMemberHistory.deceasedString [ string ]
  fhir:FamilyMemberHistory.reasonCode [ CodeableConcept ], ... ; # 0..* Why was family member history performed?
  fhir:|
  

  fhir:FamilyMemberHistory.reasonReference [ Reference(AllergyIntolerance|Condition|DiagnosticReport|DocumentReference|Observation|
  QuestionnaireResponse) ], ... ; # 0..* Why was family member history performed?
  fhir:FamilyMemberHistory.note [ Annotation ], ... ; # 0..* General note about related person
  fhir:FamilyMemberHistory.condition [ # 0..* Condition that the related person had
    fhir:FamilyMemberHistory.condition.code [ CodeableConcept ]; # 1..1 Condition suffered by relation
    fhir:FamilyMemberHistory.condition.outcome [ CodeableConcept ]; # 0..1 deceased | permanent disability | etc.
    fhir:FamilyMemberHistory.condition.contributedToDeath [ boolean ]; # 0..1 Whether the condition contributed to the cause of death
    # FamilyMemberHistory.condition.onset[x] : 0..1 When condition first manifested. One of these 4
      fhir:FamilyMemberHistory.condition.onsetAge [ Age ]
      fhir:FamilyMemberHistory.condition.onsetRange [ Range ]
      fhir:FamilyMemberHistory.condition.onsetPeriod [ Period ]
      fhir:FamilyMemberHistory.condition.onsetString [ string ]
    fhir:FamilyMemberHistory.condition.note [ Annotation ], ... ; # 0..* Extra information about condition
  ], ...;
]

Changes since Release 3 4

FamilyMemberHistory.instantiatesCanonical Added Element FamilyMemberHistory.instantiatesUri Added Element
FamilyMemberHistory
FamilyMemberHistory.status FamilyMemberHistory.sex
  • Change value set from http://hl7.org/fhir/ValueSet/history-status http://build.fhir.org/valueset-administrative-gender.html to http://hl7.org/fhir/ValueSet/history-status|4.0.1 FamilyMemberHistory.dataAbsentReason Added Element FamilyMemberHistory.sex Added Element FamilyMemberHistory.estimatedAge No longer marked as Modifier FamilyMemberHistory.reasonReference Type Reference: Added Target Types DiagnosticReport, DocumentReference FamilyMemberHistory.condition.contributedToDeath Added Element FamilyMemberHistory.definition deleted FamilyMemberHistory.notDone deleted FamilyMemberHistory.notDoneReason deleted FamilyMemberHistory.gender deleted http://hl7.org/fhir/ValueSet/administrative-gender

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

9.4.2.1 9.4.3.1 Terminology Bindings

Path Definition Type Reference
FamilyMemberHistory.status A code that identifies the status of the family history record. Required FamilyHistoryStatus
FamilyMemberHistory.dataAbsentReason Codes describing the reason why a family member's history is not available. Example FamilyHistoryAbsentReason
FamilyMemberHistory.relationship The nature of the relationship between the patient and the related person being described in the family member history. Example v3.FamilyMember FamilyMember
FamilyMemberHistory.sex Codes describing the sex assigned at birth as documented on the birth registration. Extensible AdministrativeGender
FamilyMemberHistory.reasonCode Codes indicating why the family member history was done. Example SNOMEDCTClinicalFindings
FamilyMemberHistory.condition.code Identification of the Condition or diagnosis. Example Condition/Problem/DiagnosisCodes
FamilyMemberHistory.condition.outcome The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. Example ConditionOutcomeCodes

9.4.2.2 9.4.3.2 Constraints

id Level Location Description Expression
fhs-1 Rule (base) Can have age[x] or born[x], but not both age.empty() or born.empty()
fhs-2 Rule (base) Can only have estimatedAge if age[x] is present age.exists() or estimatedAge.empty()

9.4.2.3 9.4.3.3 Processing information about the Family Member History

The Family Member History List may contain other than FamilyMemberHistory resources. For example, a full Family History could be a List that might include a mixture of FamilyMemberHistory records as well as Observation records of things like "maternal family history of breast cancer", "number of siblings", "number of female family members with breast cancer" etc.

The List representing a patient's "family history" can include Condition and Observation records that capture "family-history" relevant assertions about the patient themselves that would typically be captured as part of a family history.

9.4.2.4 9.4.3.4 No Known Patient History, No Known Problems, and Negated Conditions

Not Reviewed, Not Asked

When a sending system does not have family history about any family members or the statement is about family history not yet being asked, then the List resource should be used to indicate the List.emptyReason="notasked".

Reviewed, None Identified for Family

After reasonable investigation that there are no known items for the family member history list, then the List resource should be used to indicate the List.emptyReason="nilknown". The List.emptyReason represents a statement about the full scope of the list (i.e. the patient or patient's agent/guardian has asserted that there are no conditions or significant events for any family members to record).

Reviewed, None Identified for a Family Member

When an individual family member's history is not available, FamilyMemberHistory.dataAbsentReason can be used to indicate why that family member's history is not available (e.g. subject unknown).

Reviewed, No Known Problems or Negated Condition for a Family Member

The FamilyMemberHistory.condition.code can be used to capture "No Known Problems" or negated conditions, such as "No history of malignant tumor of breast", for an individual family member.

9.4.3 9.4.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
code token A search by a condition code FamilyMemberHistory.condition.code 13 Resources
date date When history was recorded or last updated FamilyMemberHistory.date 17 Resources
identifier token A search by a record identifier FamilyMemberHistory.identifier 30 Resources
instantiates-canonical reference Instantiates FHIR protocol or definition FamilyMemberHistory.instantiatesCanonical
( Questionnaire , Measure , PlanDefinition , OperationDefinition , ActivityDefinition )
instantiates-uri uri Instantiates external protocol or definition FamilyMemberHistory.instantiatesUri
patient reference The identity of a subject to list family member history items for FamilyMemberHistory.patient
( Patient ) 		33 Resources
relationship token A search by a relationship type FamilyMemberHistory.relationship
sex token A search by a sex code of a family member FamilyMemberHistory.sex
status token partial | completed | entered-in-error | health-unknown FamilyMemberHistory.status