DwFamilyMemberHistory
Purpose
The purpose of this resource to provide significant health conditions for a person related to the patient relevant in the context of care for the patient.
| FamilyMemberHistory | I | FamilyMemberHistory | There are no (further) constraints on this element Element IdFamilyMemberHistory Information about patient's relatives, relevant for patient DefinitionSignificant health conditions for a person related to the patient relevant in the context of care for the patient.
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| identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier External Id(s) for this record DefinitionBusiness 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. Allows identification of the family member history as it is known by various participating systems and in a way that remains consistent across servers. 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.
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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| system | Σ | 0..1 | uriFixed Value | Element IdFamilyMemberHistory.identifier.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
http://terminology.hl7.org/CodeSystem/v3-RoleCode
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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| value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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| assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdFamilyMemberHistory.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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| instantiatesCanonical | Σ | 0..1 | canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition) | There are no (further) constraints on this element Element IdFamilyMemberHistory.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this FamilyMemberHistory. canonical(PlanDefinition | Questionnaire | ActivityDefinition | Measure | OperationDefinition) Constraints
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| instantiatesUri | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdFamilyMemberHistory.instantiatesUri Instantiates external protocol or definition DefinitionThe 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.
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| status | S Σ ?! | 1..1 | codeBinding | Element IdFamilyMemberHistory.status completed | entered-in-error DefinitionA code specifying the status of the record of the family history of a specific family member. completed | entered-in-error This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A code that identifies the status of the family history record. FamilyHistoryStatus (required)Constraints
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| dataAbsentReason | Σ | 0..1 | CodeableConcept | Element IdFamilyMemberHistory.dataAbsentReason subject-unknown | withheld | unable-to-obtain | deferred DefinitionDescribes why the family member's history is not available. This is a separate element to allow it to have a distinct binding from reasonCode. Not available in PS suite and MA Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Codes describing the reason why a family member's history is not available. FamilyHistoryAbsentReason (example)Constraints
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| patient | S Σ I | 1..1 | Reference(Patient) | There are no (further) constraints on this element Element IdFamilyMemberHistory.patient Patient history is about Alternate namesProband DefinitionThe person who this history concerns. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| date | S Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdFamilyMemberHistory.date When history was recorded or last updated DefinitionThe date (and possibly time) when the family member history was recorded or last updated. Allows determination of how current the summary is. This should be captured even if the same as the date on the List aggregating the full family history.
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| name | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.name The family member described DefinitionThis will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair". Allows greater ease in ensuring the same person is being talked about. Note that FHIR strings SHALL NOT exceed 1MB in size
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| relationship | S Σ | 1..1 | CodeableConcept | Element IdFamilyMemberHistory.relationship Relationship to the subject DefinitionThe type of relationship this person has to the patient (father, mother, brother etc.). PS Suite: May be present as discrete data, but is commonly part of a string. Will be provided when available. MedAccess: May be present as discrete data. Will be provided when available. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The nature of the relationship between the patient and the related person being described in the family member history. v3.FamilyMember (example)Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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| system | Σ | 0..1 | uriFixed Value | Element IdFamilyMemberHistory.relationship.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://tgateway.infoway-inforoute.ca/vs/familymemberrelationshipcode
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.relationship.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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| sex | Σ | 0..1 | CodeableConceptBinding | Element IdFamilyMemberHistory.sex male | female | other | unknown DefinitionThe birth sex of the family member. Not all relationship codes imply sex and the relative's sex can be relevant for risk assessments. PS Suite: N/A MedAccess N/A 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. Codes describing the sex assigned at birth as documented on the birth registration. AdministrativeGender (extensible)Constraints
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| born[x] | I | 0..1 | Element IdFamilyMemberHistory.born[x] (approximate) date of birth DefinitionThe actual or approximate date of birth of the relative. Allows calculation of the relative's age. PS Suite: N/A MedAccess: N/A A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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| bornPeriod | Period | There are no (further) constraints on this element Data Type | ||
| bornDate | date | There are no (further) constraints on this element Data Type | ||
| bornString | string | There are no (further) constraints on this element Data Type | ||
| age[x] | S Σ I | 0..1 | Element IdFamilyMemberHistory.age[x] (approximate) age DefinitionThe age of the relative at the time the family member history is recorded. While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians. PS Suite: N/A Med Access: Available when documented use estimatedAge to indicate whether the age is actual or not.
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| ageAge | Age | There are no (further) constraints on this element Data Type | ||
| ageRange | Range | There are no (further) constraints on this element Data Type | ||
| ageString | string | There are no (further) constraints on this element Data Type | ||
| estimatedAge | S Σ I | 0..1 | boolean | Element IdFamilyMemberHistory.estimatedAge Age is estimated? DefinitionIf true, indicates that the age value specified is an estimated value. Clinicians often prefer to specify an estimaged age rather than an age range. PS Suite: Available when entered as estimated age Med Access: N/A 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.
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| deceased[x] | S Σ | 0..1 | Element IdFamilyMemberHistory.deceased[x] Dead? How old/when? DefinitionDeceased flag or the actual or approximate age of the relative at the time of death for the family member history record. PS Suite: Available when entered as structured data Depending on documentation could be sent as deceasedBoolean or deceasedAge Med Access: N/A
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| deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||
| deceasedAge | Age | There are no (further) constraints on this element Data Type | ||
| deceasedRange | Range | There are no (further) constraints on this element Data Type | ||
| deceasedDate | date | There are no (further) constraints on this element Data Type | ||
| deceasedString | string | There are no (further) constraints on this element Data Type | ||
| reasonCode | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdFamilyMemberHistory.reasonCode Why was family member history performed? DefinitionDescribes why the family member history occurred in coded or textual form. Textual reasons can be captured using reasonCode.text. Codes indicating why the family member history was done. SNOMEDCTClinicalFindings (example)Constraints
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| reasonReference | Σ I | 0..1 | Reference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdFamilyMemberHistory.reasonReference Why was family member history performed? DefinitionIndicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | AllergyIntolerance | QuestionnaireResponse | DiagnosticReport | DocumentReference) Constraints
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| note | S | 0..* | Annotation | Element IdFamilyMemberHistory.note General note about related person DefinitionThis 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. PS Suite: When data not enterted in a structured format text string will be provided Med Access: Notes will be provided where available For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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| condition | S | 0..* | BackboneElement | Element IdFamilyMemberHistory.condition Condition that the related person had DefinitionThe 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. PS Suite: Available when when family history is coded but will likely not be available for most patients Med Access:
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| code | S | 1..1 | CodeableConcept | There are no (further) constraints on this element Element IdFamilyMemberHistory.condition.code Condition suffered by relation DefinitionThe 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. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Identification of the Condition or diagnosis. Condition/Problem/DiagnosisCodes (example)Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdFamilyMemberHistory.condition.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdFamilyMemberHistory.condition.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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| outcome | 0..1 | CodeableConcept | Element IdFamilyMemberHistory.condition.outcome deceased | permanent disability | etc. DefinitionIndicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation. PS Suite: Available when entered as structured data May be entered as age or estimated age Med Access: Available when documented Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. ConditionOutcomeCodes (example)Constraints
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| contributedToDeath | 0..1 | boolean | There are no (further) constraints on this element Element IdFamilyMemberHistory.condition.contributedToDeath Whether the condition contributed to the cause of death DefinitionThis condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown.
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| onset[x] | S | 0..1 | Element IdFamilyMemberHistory.condition.onset[x] When condition first manifested DefinitionEither 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. Age of onset of a condition in relatives is predictive of risk for the patient. PS Suite: Med Access: Available when documented The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| onsetAge | Age | There are no (further) constraints on this element Data Type | ||
| onsetRange | Range | There are no (further) constraints on this element Data Type | ||
| onsetPeriod | Period | There are no (further) constraints on this element Data Type | ||
| onsetString | string | There are no (further) constraints on this element Data Type | ||
| note | 0..* | Annotation | There are no (further) constraints on this element Element IdFamilyMemberHistory.condition.note Extra information about condition DefinitionAn area where general notes can be placed about this specific condition. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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Usage note
Bundle
Example
{
"id": "pss-CDK5-FamilyMemberHistory-5745396",
"resourceType": "FamilyMemberHistory",
"meta": {
"source": "urn:telus:emr:pss:CDK5",
"lastUpdated": "2023-01-25T13:51:06.000Z",
"security": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code": "N",
"display": "normal"
}
]
},
"identifier": [
{
"system": "urn:telus:emr:pss:CDK5:FamilyMemberHistory",
"use": "official",
"value": "5745396"
}
],
"status": "completed",
"patient": {
"reference": "Patient/pss-CDK5-Patient-133015",
"type": "Patient"
},
"date": "2023-01-04T14:25:35",
"relationship": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "72705000",
"display": "Mother"
}
],
"text": "mother"
},
"deceasedAge": {
"value": 74
},
"note": [
{
"authorReference": {
"reference": "Practitioner/pss-CDK5-Practitioner-15",
"display": "Dr. Hanna Hook",
"type": "Practitioner"
},
"time": "2022-12-22T00:00:00",
"text": "these are extra details that the clinic would like to document about the family history"
}
],
"condition": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/icd-9-cm",
"code": "433.31",
"display": "Multiple and Bilateral Precerebral Occlusion with Cerebral Infarction",
"userSelected": true
},
{
"system": "http://hl7.org/fhir/sid/icd-9-cm",
"code": "401",
"display": "Essential Hypertension",
"userSelected": true
},
{
"system": "http://hl7.org/fhir/sid/icd-9-cm",
"code": "250",
"display": "Diabetes Mellitus",
"userSelected": true
}
],
"text": "DM, HTN, CVA"
},
"note": [
{
"text": "Long details: these are extra details that the clinic would like to document about the family history"
}
],
"contributedToDeath": true,
"outcome": {
"text": "stroke"
}
}
]
}