CA Core+ v1.1.0 DFT-preBallot
1.1.0-DFT-preBallot 
DFT-preBallot - The specification is a DFT-preBallot version of CA Core+ for collecting community feedback. For a full list of available versions, see the Directory of published versions
FamilyMemberHistory (CA-Core)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory
Examples
example-familymemberhistory-ca-core
Description
This profile applies constraints to the FamilyMemberHistory resource for CA Core+ to support capture of familial conditions in the pan-Canadian context.
References to this resource
CFMM: 2
Resource Content
| FamilyMemberHistoryCACore (FamilyMemberHistory) | C | FamilyMemberHistory | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition) |
| instantiatesUri | Σ | 0..* | uri |
| status | Σ ?! | 1..1 | codeBinding |
| dataAbsentReason | Σ | 0..1 | CodeableConcept |
| patient | Σ | 1..1 | Reference(PatientCACore) |
| date | Σ | 0..1 | dateTime |
| name | Σ | 0..1 | string |
| relationship | Σ | 1..1 | CodeableConcept |
| sex | Σ | 0..1 | CodeableConceptBinding |
| born[x] | C | 0..1 | |
| bornPeriod | Period | ||
| bornDate | date | ||
| bornString | string | ||
| age[x] | Σ C | 0..1 | |
| ageAge | Age | ||
| ageRange | Range | ||
| ageString | string | ||
| estimatedAge | Σ C | 0..1 | boolean |
| deceased[x] | Σ | 0..1 | |
| deceasedBoolean | boolean | ||
| deceasedAge | Age | ||
| deceasedRange | Range | ||
| deceasedDate | date | ||
| deceasedString | string | ||
| reasonCode | Σ | 0..* | CodeableConcept |
| reasonReference | Σ | 0..* | Reference(ConditionCACore | Observation | AllergyIntoleranceCACore | QuestionnaireResponse | DiagnosticReport | DocumentReference) |
| note | 0..* | Annotation | |
| condition | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| outcome | 0..1 | CodeableConcept | |
| contributedToDeath | 0..1 | boolean | |
| onset[x] | 0..1 | ||
| onsetAge | Age | ||
| onsetRange | Range | ||
| onsetPeriod | Period | ||
| onsetString | string | ||
| note | 0..* | Annotation |
| FamilyMemberHistoryCACore (FamilyMemberHistory) | C | FamilyMemberHistory | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition) |
| instantiatesUri | Σ | 0..* | uri |
| status | Σ ?! | 1..1 | codeBinding |
| dataAbsentReason | Σ | 0..1 | CodeableConcept |
| patient | Σ | 1..1 | Reference(PatientCACore) |
| date | Σ | 0..1 | dateTime |
| name | Σ | 0..1 | string |
| relationship | Σ | 1..1 | CodeableConcept |
| sex | Σ | 0..1 | CodeableConceptBinding |
| born[x] | C | 0..1 | |
| bornPeriod | Period | ||
| bornDate | date | ||
| bornString | string | ||
| age[x] | Σ C | 0..1 | |
| ageAge | Age | ||
| ageRange | Range | ||
| ageString | string | ||
| estimatedAge | Σ C | 0..1 | boolean |
| deceased[x] | Σ | 0..1 | |
| deceasedBoolean | boolean | ||
| deceasedAge | Age | ||
| deceasedRange | Range | ||
| deceasedDate | date | ||
| deceasedString | string | ||
| reasonCode | Σ | 0..* | CodeableConcept |
| reasonReference | Σ | 0..* | Reference(ConditionCACore | Observation | AllergyIntoleranceCACore | QuestionnaireResponse | DiagnosticReport | DocumentReference) |
| note | 0..* | Annotation | |
| condition | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| outcome | 0..1 | CodeableConcept | |
| contributedToDeath | 0..1 | boolean | |
| onset[x] | 0..1 | ||
| onsetAge | Age | ||
| onsetRange | Range | ||
| onsetPeriod | Period | ||
| onsetString | string | ||
| note | 0..* | Annotation |
</extension>
<url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/familymemberhistory-ca-core" />
</telecom>
</telecom>
</contact>
<description value="This profile applies constraints to the FamilyMemberHistory resource for CA Core+ to support capture of familial conditions in the pan-Canadian context." />
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<comment value="Mapping for FamilyMemberHistoryCACore to Canadian Core Data for Interoperability (CACDI)." />
</mapping>
<definition value="Significant health conditions for a person related to the patient relevant in the context of care for the patient." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
<xpath value="not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')])" />
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
</base>
</type>
</constraint>
</element>
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
</element>
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
</base>
</type>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. 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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
<definition value="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." />
<comment value="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." />
<requirements value="Allows identification of the family member history as it is known by various participating systems and in a way that remains consistent across servers." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="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." />
<comment value="This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="A code specifying the status of the record of the family history of a specific family member." />
<comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</extension>
</binding>
</mapping>
</mapping>
</element>
<requirements value="This is a separate element to allow it to have a distinct binding from reasonCode." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The date (and possibly time) when the family member history was recorded or last updated." />
<comment value="This should be captured even if the same as the date on the List aggregating the full family history." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair"." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="The type of relationship this person has to the patient (father, mother, brother etc.)." />
</base>
</type>
</constraint>
</extension>
<description value="The nature of the relationship between the patient and the related person being described in the family member history." />
</binding>
</mapping>
</element>
<comment value="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 value="Not all relationship codes imply sex and the relative's sex can be relevant for risk assessments." />
</base>
</type>
</constraint>
</extension>
<description value="Codes describing the sex assigned at birth as documented on the birth registration." />
</binding>
</element>
</base>
</type>
</type>
</type>
</constraint>
</mapping>
</element>
<requirements value="While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians." />
</base>
</type>
</type>
</type>
</constraint>
</mapping>
</element>
<comment 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." />
<requirements value="Clinicians often prefer to specify an estimaged age rather than an age range." />
</base>
</type>
</constraint>
</element>
<definition value="Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record." />
</base>
</type>
</type>
</type>
</type>
</type>
</constraint>
<map value="player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG) For age, you'd hang an observation off the role" />
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event." />
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/allergyintolerance-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</mapping>
<map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value" />
</mapping>
</element>
<definition value="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." />
</base>
</type>
</constraint>
<map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]" />
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
<definition value="Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation." />
</base>
</type>
</constraint>
</extension>
<description value="The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc." />
</binding>
<map value="outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value" />
</mapping>
</element>
<definition value="This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown." />
</base>
</type>
</constraint>
</element>
<definition value="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 value="Age of onset of a condition in relatives is predictive of risk for the patient." />
</base>
</type>
</type>
</type>
</type>
</constraint>
<map value="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" />
</mapping>
</element>
</base>
</type>
</constraint>
<map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value" />
</mapping>
</element>
</snapshot>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</mapping>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/allergyintolerance-ca-core" />
</type>
</element>
</differential>
</StructureDefinition>
{
],
{
{
},
{
}
]
}
],
"description": "This profile applies constraints to the FamilyMemberHistory resource for CA Core+ to support capture of familial conditions in the pan-Canadian context.",
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
"comment": "Mapping for FamilyMemberHistoryCACore to Canadian Core Data for Interoperability (CACDI)."
}
],
{
"definition": "Significant health conditions for a person related to the patient relevant in the context of care for the patient.",
},
{
},
{
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
},
{
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
},
],
{
}
],
},
{
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
},
{
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
"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.",
"comment": "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.",
"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.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"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.",
},
{
"http://hl7.org/fhir/StructureDefinition/PlanDefinition",
"http://hl7.org/fhir/StructureDefinition/Questionnaire",
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/Measure",
"http://hl7.org/fhir/StructureDefinition/OperationDefinition"
]
}
],
{
}
],
{
},
{
}
]
},
{
"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.",
"comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
},
],
{
}
],
{
},
{
}
]
},
{
"definition": "A code specifying the status of the record of the family history of a specific family member.",
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
},
],
{
}
],
"isModifierReason": "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",
{
}
],
},
]
},
{
"requirements": "This is a separate element to allow it to have a distinct binding from reasonCode.",
},
],
{
}
],
{
}
],
},
]
},
{
"Proband"
],
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The date (and possibly time) when the family member history was recorded or last updated.",
"comment": "This should be captured even if the same as the date on the List aggregating the full family history.",
},
],
{
}
],
{
},
{
}
]
},
{
"definition": "This will either be a name or a description; e.g. \"Aunt Susan\", \"my cousin with the red hair\".",
},
],
{
}
],
]
},
{
"definition": "The type of relationship this person has to the patient (father, mother, brother etc.).",
},
],
{
}
],
{
}
],
"description": "The nature of the relationship between the patient and the related person being described in the family member history.",
},
]
},
{
"comment": "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.",
},
],
{
}
],
{
}
],
"description": "Codes describing the sex assigned at birth as documented on the birth registration.",
}
},
{
},
],
"fhs-1"
],
{
}
],
{
}
]
},
{
"requirements": "While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians.",
},
],
"fhs-1"
],
{
}
],
{
}
]
},
{
"comment": "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.",
},
],
"fhs-2"
],
{
}
],
},
{
"definition": "Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.",
},
{
},
{
},
{
},
{
},
{
}
],
{
}
],
{
"map": "player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG) For age, you'd hang an observation off the role"
}
]
},
{
},
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
"definition": "Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/allergyintolerance-ca-core",
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
"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.",
},
],
{
}
],
{
},
{
"map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value"
}
]
},
{
"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.",
},
],
{
}
],
{
"map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]"
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"definition": "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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"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.",
},
],
{
}
],
{
}
],
},
]
},
{
"definition": "Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation.",
},
],
{
}
],
{
}
],
"description": "The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.",
},
{
"map": "outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value"
}
]
},
{
"definition": "This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.",
},
],
{
}
],
},
{
"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.",
},
],
{
}
],
{
"map": "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"
}
]
},
{
},
],
{
}
],
{
"map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value"
}
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
]
}
],
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/allergyintolerance-ca-core",
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
]
}
]
}
}
Terminology bindings
Additional Terminology Bindings
These bindings may be used in lieu of the primary bindings in the table above.
Mappings to CACDI
The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.
| FHIR Profile Element | CACDI Element(s) |
|---|---|
| FamilyMemberHistory.patient | Patient |