type: resourceresource: FamilyMemberHistory

FamilyMemberHistory

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.

Notes

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.

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, No Information Available 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.

StructureDefinition

Elements (Simplified)

FamilyMemberHistory [0..*]: - Information about patient's relatives, relevant for patient
FamilyMemberHistory.identifier [0..*]: Identifier External Id(s) for this record
FamilyMemberHistory.status [1..1]: code required:history-status partial | completed | entered-in-error | health-unknown
FamilyMemberHistory.dataAbsentReason [0..1]: CodeableConcept example:history-absent-reason subject-unknown | withheld | unable-to-obtain | deferred
FamilyMemberHistory.patient [1..1]: Reference(Patient) Patient history is about
FamilyMemberHistory.date [0..1]: dateTime When history was recorded or last updated
FamilyMemberHistory.recorder [0..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Patient, RelatedPerson, Organization, CareTeam, Group)) Who recorded the family member history
FamilyMemberHistory.asserter [0..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Patient, RelatedPerson, Organization, CareTeam, Device, Group)) Person or device that asserts this family member history
FamilyMemberHistory.name [0..1]: string The family member described
FamilyMemberHistory.relationship [1..1]: CodeableConcept example:v3-FamilyMember Relationship to the subject
FamilyMemberHistory.sex [0..1]: CodeableConcept extensible:administrative-gender male | female | other | unknown
FamilyMemberHistory.born[x] [0..1]: Period, date, string (approximate) date of birth
FamilyMemberHistory.age[x] [0..1]: Age, Range, string (approximate) age
FamilyMemberHistory.estimatedAge [0..1]: boolean Age is estimated?
FamilyMemberHistory.deceased[x] [0..1]: boolean, Age, Range, date, string Dead? How old/when?
FamilyMemberHistory.reason [0..*]: CodeableReference example:clinical-findings Why was family member history performed?
FamilyMemberHistory.note [0..*]: Annotation General note about related person
FamilyMemberHistory.condition [0..*]: BackboneElement Condition that the related person had
FamilyMemberHistory.condition.code [1..1]: CodeableConcept example:condition-code Condition, allergy, or intolerance suffered by relation
FamilyMemberHistory.condition.outcome [0..1]: CodeableConcept example:condition-outcome deceased | permanent disability | etc
FamilyMemberHistory.condition.contributedToDeath [0..1]: boolean Whether the condition contributed to the cause of death
FamilyMemberHistory.condition.onset[x] [0..1]: Age, Range, Period, string When condition first manifested
FamilyMemberHistory.condition.note [0..*]: Annotation Extra information about condition
FamilyMemberHistory.procedure [0..*]: BackboneElement Procedures that the related person had
FamilyMemberHistory.procedure.code [1..1]: CodeableConcept example:procedure-code Procedures performed on the related person
FamilyMemberHistory.procedure.outcome [0..1]: CodeableConcept example:clinical-findings What happened following the procedure
FamilyMemberHistory.procedure.contributedToDeath [0..1]: boolean Whether the procedure contributed to the cause of death
FamilyMemberHistory.procedure.performed[x] [0..1]: Age, Range, Period, string, dateTime When the procedure was performed
FamilyMemberHistory.procedure.note [0..*]: Annotation Extra information about the procedure

Mappings

FamilyMemberHistory Mappings — 35 mapping entries

Implementation Guide

implementationguide-FamilyMemberHistory-core.xml

<?xml version="1.0" encoding="UTF-8"?>

<ImplementationGuide xmlns="http://hl7.org/fhir">
  <id value="FamilyMemberHistory-core"/>
  <version value="0.1"/>
  <name value="FamilyMemberHistoryHL7Extensions"/>
  <title value="Family  Member  History  H L7  Extensions"/>
  <status value="draft"/>
  <date value="2015-02-21T00:00:00.000"/>
  <publisher value="Health Level Seven, Inc. - FHIR WG"/>
  <description value="Defines common extensions used with or related to the FamilyMemberHistory resource"/>
  <definition>
    <resource>
      <reference>
        <reference value="StructureDefinition/familymemberhistory-genetic"/>
      </reference>
    </resource>
  </definition>
</ImplementationGuide>

Resource Packs

list-FamilyMemberHistory-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir">
  <id value="FamilyMemberHistory-packs"/>
  <status value="current"/>
  <mode value="working"/>
  <entry>
    <item>
      <reference value="ImplementationGuide/FamilyMemberHistory-core"/>
    </item>
  </entry>
</List>

Search Parameters

code — token — A search by a condition code — FamilyMemberHistory.condition.code
date — date — When history was recorded or last updated — FamilyMemberHistory.date
identifier — token — A search by a record identifier — FamilyMemberHistory.identifier
patient — reference — The identity of a subject to list family member history items for — FamilyMemberHistory.patient
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

Full Search Parameters

Examples

familymemberhistory-example — familymemberhistory-example
familymemberhistory-example-mother — familymemberhistory-example-mother
familymemberhistory-example-negation — familymemberhistory-example-negation
familymemberhistory-examples-header — familymemberhistory-examples-header
father — familymemberhistory-example — Basic Example. Describes the fathers death at age 74 from a heart attack
mother — familymemberhistory-example-mother — Mother died from a stroke aged 56. Brother with diabetes.
negation — familymemberhistory-example-negation — Mother has no history of malignant tumor of breast

Full Examples

Mapping Exceptions

familymemberhistory-event-mapping-exceptions.xml

Divergent Elements

Event.identifier → FamilyMemberHistory.identifier
- shortUnmatched | reason=Unknown | pattern=Business identifier for family member history | resource=External Id(s) for this record
- definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this family member history by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=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.
- commentsUnmatched | reason=Unknown | pattern=Note: 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. | resource=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.
Event.status → FamilyMemberHistory.status
- shortUnmatched | reason=Unknown | pattern=preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown | resource=partial | completed | entered-in-error | health-unknown
- definitionUnmatched | reason=Unknown | pattern=The current state of the family member history. | resource=A code specifying the status of the record of the family history of a specific family member.
- commentsUnmatched | reason=Unknown | pattern=A nominal state-transition diagram can be found in the (Event pattern documentation

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | resource=This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Event.subject → FamilyMemberHistory.patient
- missingTypes | reason=Unknown | pattern=Reference(Group)
- shortUnmatched | reason=Unknown | pattern=Individual service was done for/to | resource=Patient history is about
- definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is being or was performed on. | resource=The person who this history concerns.
- requirementsUnmatched | reason=Unknown | pattern=Links the family member history to the Patient context. May also affect access control.
Event.reason → FamilyMemberHistory.reason
- definitionUnmatched | reason=Unknown | pattern=Describes why the family member history occurred in coded or textual form or Indicates another resource whose existence justifies this family member history. | resource=Describes why the family member history occurred in coded or textual form, or Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.
Event.note → FamilyMemberHistory.note
- shortUnmatched | reason=Unknown | pattern=Comments made about the event | resource=General note about related person
- definitionUnmatched | reason=Unknown | pattern=Comments made about the family member history by the performer, subject or other participants. | resource=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.

Unmapped Elements

Event.partOf — Unknown
Event.reported — Unknown
Event.relevantHistory — Unknown
Event.code — Unknown
Event.location — Unknown
Event.statusReason — Unknown
Event.performer.actor — Unknown
Event.performer.function — Unknown
Event.category — Unknown
Event.encounter — Unknown
Event.recorded — Unknown
Event.occurrence — Unknown
Event.product — Unknown
Event.performer — Unknown

familymemberhistory-fivews-mapping-exceptions.xml

Unmapped Elements

FiveWs.what — Unknown
FiveWs.actor — Unknown
FiveWs.cause — Unknown
FiveWs.version — Unknown
FiveWs.witness — Unknown
FiveWs.class — Unknown
FiveWs.where — Unknown
FiveWs.context — Unknown
FiveWs.init — Unknown
FiveWs.who — Unknown
FiveWs.grade — Unknown
FiveWs.planned — Unknown
FiveWs.done — Unknown