TELUS DW Generic FHIR Extract

There are no (further) constraints on this element

Element id

FamilyMemberHistory.implicitRules

Short description

A set of rules under which this content was created

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.

Comments

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

FamilyMemberHistory.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

FamilyMemberHistory.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

Comments

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

FamilyMemberHistory.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

Comments

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.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

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.

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

Element id

FamilyMemberHistory.identifier

Short description

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.

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: identifier.system = urn:telus:emr:chr:{region}:{accountId}:FamilyMemberHistory

Data type

Identifier

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
rim: id

instantiatesCanonical

0..*

canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)

There are no (further) constraints on this element

Element id

FamilyMemberHistory.instantiatesCanonical

Short description

Instantiates FHIR protocol or definition

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.

Comments

see Canonical References

Data type

canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.instantiatesCanonical
rim: .outboundRelationship[typeCode=DEFN].target

instantiatesUri

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.instantiatesUri

Short description

Instantiates external protocol or definition

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.

Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Data type

FamilyHistoryStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.instantiatesUri
rim: .outboundRelationship[typeCode=DEFN].target

status

S Σ ?!

1..1

codeBinding

Element id

FamilyMemberHistory.status

Short description

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Status derived from archived flag and confirmation state — entered-in-error when archived, completed when confirmed, partial when not yet confirmed. MA/PSS: EMR status mapped to FHIR history-status values.

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

Data type

code

Binding

A code that identifies the status of the family history record.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status

dataAbsentReason

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.dataAbsentReason

Short description

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.

Comments

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.

Data type

FamilyHistoryAbsentReason (example)

Binding

Codes describing the reason why a family member's history is not available.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .reasonCode

patient

S Σ C

1..1

Reference(DwPatient)

Element id

FamilyMemberHistory.patient

Short description

Patient history is about

Alternate names

Proband

Definition

The person who this history concerns.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Data type

Reference(DwPatient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
rim: participation[typeCode=SBJ].role
w5: FiveWs.subject

date

S Σ

0..1

Element id

FamilyMemberHistory.date

Short description

When history was recorded or last updated

Definition

The date (and possibly time) when the family member history was recorded or last updated.

Requirements

Allows determination of how current the summary is.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
w5: FiveWs.recorded
rim: participation[typeCode=AUT].time

name

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.name

Short description

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: name

relationship

S Σ

1..1

CodeableConceptBinding

Element id

FamilyMemberHistory.relationship

Short description

Relationship to the subject

Definition

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

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Coded to SNOMED CT. 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.

Data type

https://fhir.infoway-inforoute.ca/ValueSet/familymemberrelationshipcode (preferred)

Binding

The nature of the relationship between the patient and the related person being described in the family member history.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: code

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.relationship.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.relationship.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

S Σ

0..*

Element id

FamilyMemberHistory.relationship.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: SNOMED CT coding (http://snomed.info/sct).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

text

S Σ

0..1

Element id

FamilyMemberHistory.relationship.text

Short description

Plain text representation of the concept

Definition

A 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.

Requirements

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Display text from the SNOMED relationship mapping. MA - Concatenate Relation and maternal/paternal fields together PSS - Family member field if documented in structured format. Otherwise provide full short description

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

sex

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

FamilyMemberHistory.sex

Short description

male | female | other | unknown

Definition

The birth sex of the family member.

Requirements

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

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.

Data type

AdministrativeGender (extensible)

Binding

Codes describing the sex assigned at birth as documented on the birth registration.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

born[x]

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.born[x]

Short description

(approximate) date of birth

Definition

The actual or approximate date of birth of the relative.

Requirements

Allows calculation of the relative's age.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, fhs-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

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

bornDate

There are no (further) constraints on this element

Data type

bornPeriod

There are no (further) constraints on this element

Data type

bornString

There are no (further) constraints on this element

Data type

age[x]

Σ C

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.age[x]

Short description

(approximate) age

Definition

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

Requirements

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

Comments

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, fhs-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

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

ageAge

There are no (further) constraints on this element

Data type

ageRange

There are no (further) constraints on this element

Data type

ageString

There are no (further) constraints on this element

Data type

estimatedAge

Σ C

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.estimatedAge

Short description

Age is estimated?

Definition

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

Requirements

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

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.

Meaning when missing

It is unknown whether the age is an estimate or not

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, fhs-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

deceased[x]

S Σ

0..1

Element id

FamilyMemberHistory.deceased[x]

Short description

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.

Comments

EMR Support:

CHR: 🔴 Not Supported
MA: 🔴 Not Supported
PSS: 🟢 populate-if-known

PS Suite: Available when entered as structured data Depending on documentation could be sent as deceasedBoolean or deceasedstring Med Access: N/A

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

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

deceasedAge

There are no (further) constraints on this element

Data type

deceasedBoolean

There are no (further) constraints on this element

Data type

deceasedDate

There are no (further) constraints on this element

Data type

deceasedRange

There are no (further) constraints on this element

Data type

deceasedString

There are no (further) constraints on this element

Data type

reasonCode

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.reasonCode

Short description

Why was family member history performed?

Definition

Describes why the family member history occurred in coded or textual form.

Comments

Textual reasons can be captured using reasonCode.text.

Data type

SNOMEDCTClinicalFindings (example)

Binding

Codes indicating why the family member history was done.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
rim: .reasonCode

reasonReference

Σ C

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.reasonReference

Short description

Why was family member history performed?

Definition

Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event.

Comments

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
rim: .outboundRelationship[typeCode=RSON].target

note

0..*

Element id

FamilyMemberHistory.note

Short description

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Notes field from the family history record. Only emitted when a diagnosis is present. MA: May concatenate age/paternal/maternal context with the note text. PSS: Note text from the family history record.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Event.note
rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value

condition

0..*

BackboneElement

Element id

FamilyMemberHistory.condition

Short description

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: One FamilyMemberHistory resource is generated per diagnosis; condition is always populated when a diagnosis exists. MA: Available when family history has a coded diagnosis. PSS: Available when family history is coded.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

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

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

code

1..1

CodeableConceptBinding

Element id

FamilyMemberHistory.condition.code

Short description

Condition suffered by relation

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Coded to ICD-9, ICD-10, SNOMED, or ENCODE based on the diagnosis template.

Data type

https://www.telus.com/health/fhir/dwemrextract/ValueSet/combined-condition-codes (required)

Binding

Identification of the Condition or diagnosis.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .value

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.code.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

text

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.code.text

Short description

Plain text representation of the concept

Definition

A 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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

outcome

0..1

Element id

FamilyMemberHistory.condition.outcome

Short description

deceased | permanent disability | etc.

Definition

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

Comments

EMR Support:

CHR: 🔴 Not Supported
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

PS Suite: Available when entered as structured data Med Access: Available when documented

Data type

ConditionOutcomeCodes (example)

Binding

The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value

contributedToDeath

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.contributedToDeath

Short description

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

onset[x]

0..1

Element id

FamilyMemberHistory.condition.onset[x]

Short description

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.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: onsetAge when an age at onset is recorded, onsetString for a life stage (when no age), onsetPeriod from start and end dates (when no age or life stage). MA: onset date. PSS: onset string, onset period start, or onset age.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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

onsetAge

There are no (further) constraints on this element

Data type

onsetPeriod

There are no (further) constraints on this element

Data type

onsetRange

There are no (further) constraints on this element

Data type

onsetString

There are no (further) constraints on this element

Data type

note

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.note

Short description

Extra information about condition

Definition

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

Comments

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).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.note.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.note.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

author[x]

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

authorReference

Reference(Organization | Patient | Practitioner | RelatedPerson)

There are no (further) constraints on this element

Data type

Reference(Organization | Patient | Practitioner | RelatedPerson)

authorString

There are no (further) constraints on this element

Data type

time

0..1

There are no (further) constraints on this element

Element id

FamilyMemberHistory.condition.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type