Path | Short | Definition | Comments |
---|---|---|---|
Information about patient's relatives, relevant for patient | Significant health conditions for a person related to the patient relevant in the context of care for the patient. | ||
identifier | External Id(s) for this record | 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. | This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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. |
instantiatesCanonical | Instantiates FHIR protocol or 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. | |
instantiatesUri | Instantiates external protocol or 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. | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. |
status | partial | completed | entered-in-error | health-unknown | A code specifying the status of the record of the family history of a specific family member. | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
dataAbsentReason | subject-unknown | withheld | unable-to-obtain | deferred | Describes why the family member's history is not available. | |
patient | Patient history is about | The person who this history concerns. | |
date | When history was recorded or last updated | The date (and possibly time) when the family member history was recorded or last updated. | This should be captured even if the same as the date on the List aggregating the full family history. |
name | The family member described | This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair". | |
relationship | Relationship to the subject | The type of relationship this person has to the patient (father, mother, brother etc.). | |
sex | male | female | other | unknown | The birth sex of the family member. | 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. |
born[x] | (approximate) date of birth | The actual or approximate date of birth of the relative. | |
age[x] | (approximate) age | The age of the relative at the time the family member history is recorded. | use estimatedAge to indicate whether the age is actual or not. |
estimatedAge | Age is estimated? | If true, indicates that the age value specified is an estimated value. | 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. |
deceased[x] | Dead? How old/when? | Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record. | |
reasonCode | Why was family member history performed? | Describes why the family member history occurred in coded or textual form. | Textual reasons can be captured using reasonCode.text. |
reasonReference | Why was family member history performed? | Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event. | |
note | General note about related person | 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. | |
condition | Condition that the related person had | 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.id | Unique id for inter-element referencing | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
condition.extension | Additional content defined by implementations | 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. | 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. |
condition.modifierExtension | Extensions that cannot be ignored even if unrecognized | 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). | 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. |
condition.code | Condition suffered by relation | 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. | |
condition.outcome | deceased | permanent disability | etc. | Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation. | |
condition.contributedToDeath | Whether the condition contributed to the cause of death | This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown. | |
condition.onset[x] | When condition first manifested | 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. | |
condition.note | Extra information about condition | An area where general notes can be placed about this specific condition. |
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.
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.
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.
gender | A search by a gender code of a family member | undefined |
instantiates-canonical | Instantiates FHIR protocol or definition | FamilyMemberHistory.instantiatesCanonical |
instantiates-uri | Instantiates external protocol or definition | FamilyMemberHistory.instantiatesUri |
relationship | A search by a relationship type | FamilyMemberHistory.relationship |
status | partial | completed | entered-in-error | health-unknown | FamilyMemberHistory.status |
Adds additional information to a family member history supporting both the capture of mother/father relationships as well as additional observations necessary to enable genetics-based risk analysis for patients
Path | Short | Definition | Comments |
---|---|---|---|
Information about patient's relatives, relevant for patient | Significant health conditions for a person related to the patient relevant in the context of care for the patient. | ||
identifier | External Id(s) for this record | 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. | This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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. |
instantiatesCanonical | Instantiates FHIR protocol or 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. | |
instantiatesUri | Instantiates external protocol or 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. | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. |
status | partial | completed | entered-in-error | health-unknown | A code specifying the status of the record of the family history of a specific family member. | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
dataAbsentReason | subject-unknown | withheld | unable-to-obtain | deferred | Describes why the family member's history is not available. | |
patient | Patient history is about | The person who this history concerns. | |
date | When history was recorded or last updated | The date (and possibly time) when the family member history was recorded or last updated. | This should be captured even if the same as the date on the List aggregating the full family history. |
name | The family member described | This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair". | |
relationship | Relationship to the subject | The type of relationship this person has to the patient (father, mother, brother etc.). | |
sex | male | female | other | unknown | The birth sex of the family member. | 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. |
born[x] | (approximate) date of birth | The actual or approximate date of birth of the relative. | |
age[x] | (approximate) age | The age of the relative at the time the family member history is recorded. | use estimatedAge to indicate whether the age is actual or not. |
estimatedAge | Age is estimated? | If true, indicates that the age value specified is an estimated value. | 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. |
deceased[x] | Dead? How old/when? | Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record. | |
reasonCode | Why was family member history performed? | Describes why the family member history occurred in coded or textual form. | Textual reasons can be captured using reasonCode.text. |
reasonReference | Why was family member history performed? | Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event. | |
note | General note about related person | 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. | |
condition | Condition that the related person had | 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.id | Unique id for inter-element referencing | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
condition.extension | Additional content defined by implementations | 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. | 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. |
condition.modifierExtension | Extensions that cannot be ignored even if unrecognized | 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). | 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. |
condition.code | Condition suffered by relation | 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. | |
condition.outcome | deceased | permanent disability | etc. | Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation. | |
condition.contributedToDeath | Whether the condition contributed to the cause of death | This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown. | |
condition.onset[x] | When condition first manifested | 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. | |
condition.note | Extra information about condition | An area where general notes can be placed about this specific condition. |