type: resource-definitionsresource: FamilyMemberHistory

FamilyMemberHistory Definitions

FamilyMemberHistory

Information about patient's relatives, relevant for patient

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

Cardinality: 0..*

Mappings: workflow=Event; v2=Not in scope for v2; rim=Observation[classCode=OBS, moodCode=EVN]; w5=clinical.general

FamilyMemberHistory.identifier

External Id(s) for this record

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.

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.

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.

Cardinality: 0..*

Type: Identifier

Summary: true

Mappings: workflow=Event.identifier; w5=FiveWs.identifier; rim=id

FamilyMemberHistory.status

partial | completed | entered-in-error | health-unknown

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

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

Cardinality: 1..1

Type: code

Binding: required:history-status

Summary: true

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)

Mappings: workflow=Event.status; w5=FiveWs.status

FamilyMemberHistory.dataAbsentReason

subject-unknown | withheld | unable-to-obtain | deferred

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

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

Cardinality: 0..1

Type: CodeableConcept

Binding: example:history-absent-reason

Summary: true

Mappings: rim=.reasonCode

FamilyMemberHistory.patient

Patient history is about

Definition: The person who this history concerns.

Comments: This is not the family member.

Aliases: Proband

Cardinality: 1..1

Type: Reference(Patient)

Summary: true

Mappings: workflow=Event.subject; w5=FiveWs.subject; rim=participation[typeCode=SBJ].role

FamilyMemberHistory.date

When history was recorded or last updated

Definition: The date (and possibly time) when the family member 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.

Requirements: Allows determination of how current the summary is.

Cardinality: 0..1

Type: dateTime

Summary: true

Mappings: w5=FiveWs.recorded; rim=participation[typeCode=AUT].time

FamilyMemberHistory.recorder

Who recorded the family member history

Definition: Individual who recorded the record and takes responsibility for its content.

Cardinality: 0..1

Type: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization, CareTeam, Group)

Summary: true

Mappings: w5=FiveWs.author; rim=.participation[typeCode=AUT].role

FamilyMemberHistory.asserter

Person or device that asserts this family member history

Definition: Individual or device that is making the family member history statement.

Cardinality: 0..1

Type: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization, CareTeam, Device, Group)

Summary: true

Mappings: w5=FiveWs.source; v2=REL-7.1 identifier + REL-7.12 type code; rim=.participation[typeCode=INF].role

FamilyMemberHistory.name

The family member described

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

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

Cardinality: 0..1

Type: string

Summary: true

Mappings: rim=name

FamilyMemberHistory.relationship

Relationship to the subject

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

Cardinality: 1..1

Type: CodeableConcept

Binding: example:v3-FamilyMember

Summary: true

Mappings: rim=code

FamilyMemberHistory.sex

male | female | other | unknown

Definition: The birth sex of the family member.

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.

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

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:administrative-gender

Summary: true

FamilyMemberHistory.born[x]

(approximate) date of birth

Definition: The actual or approximate date of birth of the relative.

Requirements: Allows calculation of the relative's age.

Conditions: fhs-1

Cardinality: 0..1

Type: Period, date, string

Mappings: rim=player[classCode=LIV, determinerCode=INSTANCE]. birthDate (could be URG)

FamilyMemberHistory.age[x]

(approximate) age

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

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

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

Conditions: fhs-2, fhs-1, fhs-3

Cardinality: 0..1

Type: Age, Range, string

Summary: true

Mappings: rim=participation[typeCode=SBJ].act[classCode=OBS,moodCode=EVN, code="age"].value

FamilyMemberHistory.estimatedAge

Age is estimated?

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

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.

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

Meaning if Missing: It is unknown whether the age is an estimate or not

Conditions: fhs-2

Cardinality: 0..1

Type: boolean

Summary: true

FamilyMemberHistory.deceased[x]

Dead? How old/when?

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

Conditions: fhs-3

Cardinality: 0..1

Type: boolean, Age, Range, date, string

Summary: true

Mappings: rim=player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG) For age, you'd hang an observation off the role

FamilyMemberHistory.reason

Why was family member history performed?

Definition: 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.

Comments: Textual reasons can be captured using reasonCode.text.

Cardinality: 0..*

Type: CodeableReference

Binding: example:clinical-findings

Summary: true

Mappings: workflow=Event.reason; w5=FiveWs.why[x]; rim=.reasonCode

FamilyMemberHistory.note

General note about related person

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

Mappings: workflow=Event.note; rim=inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value

FamilyMemberHistory.condition

Condition that the related person had

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..*

Type: BackboneElement

Summary: true

Mappings: rim=inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]

FamilyMemberHistory.condition.code

Condition, allergy, or intolerance suffered by relation

Definition: The actual condition, allergy, or intolerance 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

Type: CodeableConcept

Binding: example:condition-code

Summary: true

Mappings: rim=.value

FamilyMemberHistory.condition.outcome

deceased | permanent disability | etc

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

Cardinality: 0..1

Type: CodeableConcept

Binding: example:condition-outcome

Mappings: rim=outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value

FamilyMemberHistory.condition.contributedToDeath

Whether the condition contributed to the cause of death

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

FamilyMemberHistory.condition.onset[x]

When condition first manifested

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.

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

Cardinality: 0..1

Type: Age, Range, Period, string

Mappings: rim=inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="Subject Age at measurement", value<Diagnosis].value[@xsi:typeCode='TS' or 'IVL_TS'] Use originalText for string

FamilyMemberHistory.condition.note

Extra information about condition

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

Cardinality: 0..*

Type: Annotation

Mappings: rim=inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value

FamilyMemberHistory.procedure

Procedures that the related person had

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..*

Type: BackboneElement

FamilyMemberHistory.procedure.code

Procedures performed on the related person

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

Type: CodeableConcept

Binding: example:procedure-code

FamilyMemberHistory.procedure.outcome

What happened following the procedure

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

Cardinality: 0..1

Type: CodeableConcept

Binding: example:clinical-findings

FamilyMemberHistory.procedure.contributedToDeath

Whether the procedure contributed to the cause of death

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

FamilyMemberHistory.procedure.performed[x]

When the procedure was performed

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

FamilyMemberHistory.procedure.note

Extra information about the procedure

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

Cardinality: 0..*

Type: Annotation