<status value="draft" /> <date value="2021-04-19T13:48:45.9513368+00:00" /> <publisher value="OMD" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/patientcare/index.cfm" /> </telecom> </contact> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/fhir" /> </telecom> </contact> <description value="Significant health conditions for a person related to the patient relevant in the context of care for the patient." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="CDSS5.1" /> <uri value="www.ontariomd.com" /> <name value="CDS-S 5.1" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="FamilyMemberHistory" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> <derivation value="specialization" /> <differential> <element id="FamilyMemberHistory"> <path value="FamilyMemberHistory" /> <short value="Information about patient's relatives, relevant for patient" /> <definition value="Significant health conditions for a person related to the patient relevant in the context of care for the patient." /> <constraint> <key value="fhs-2" /> <severity value="error" /> <human value="Can only have estimatedAge if age[x] is present" /> <expression value="age.exists() or estimatedAge.empty()" /> <xpath value="exists(*[starts-with(local-name(.), 'age')]) or not(exists(f:estimatedAge))" /> <source value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" /> </constraint> <constraint> <key value="fhs-1" /> <severity value="error" /> <human value="Can have age[x] or born[x], but not both" /> <expression value="age.empty() or born.empty()" /> <xpath value="not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')])" /> <source value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" /> </constraint> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="v2" /> <map value="Not in scope for v2" /> </mapping> <mapping> <identity value="rim" /> <map value="Observation[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="FamilyMemberHistory.identifier"> <path value="FamilyMemberHistory.identifier" /> <short value="External Id(s) for this record" /> <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." /> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.identifier" /> </mapping> <mapping> <identity value="rim" /> <map value="id" /> </mapping> </element> <element id="FamilyMemberHistory.instantiatesCanonical"> <path value="FamilyMemberHistory.instantiatesCanonical" /> <short value="Instantiates FHIR protocol or definition" /> <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." /> <type> <code value="canonical" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Measure" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/OperationDefinition" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.instantiatesCanonical" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=DEFN].target" /> </mapping> </element> <element id="FamilyMemberHistory.instantiatesUri"> <path value="FamilyMemberHistory.instantiatesUri" /> <short value="Instantiates external protocol or definition" /> <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." /> <type> <code value="uri" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.instantiatesUri" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=DEFN].target" /> </mapping> </element> <element id="FamilyMemberHistory.status"> <path value="FamilyMemberHistory.status" /> <short value="partial | completed | entered-in-error | health-unknown" /> <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." /> <type> <code value="code" /> </type> <isModifier value="true" /> <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" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FamilyHistoryStatus" /> </extension> <strength value="required" /> <description value="A code that identifies the status of the family history record." /> <valueSet value="http://hl7.org/fhir/ValueSet/history-status|4.0.0" /> </binding> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.status" /> </mapping> </element> <element id="FamilyMemberHistory.dataAbsentReason"> <path value="FamilyMemberHistory.dataAbsentReason" /> <short value="subject-unknown | withheld | unable-to-obtain | deferred" /> <definition value="Describes why the family member's history is not available." /> <requirements value="This is a separate element to allow it to have a distinct binding from reasonCode." /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FamilyHistoryAbsentReason" /> </extension> <strength value="example" /> <description value="Codes describing the reason why a family member's history is not available." /> <valueSet value="http://hl7.org/fhir/ValueSet/history-absent-reason" /> </binding> <mapping> <identity value="rim" /> <map value=".reasonCode" /> </mapping> </element> <element id="FamilyMemberHistory.patient"> <path value="FamilyMemberHistory.patient" /> <short value="Patient history is about" /> <definition value="The person who this history concerns." /> <alias value="Proband" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject[x]" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ].role" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject" /> </mapping> </element> <element id="FamilyMemberHistory.date"> <path value="FamilyMemberHistory.date" /> <short value="When history was recorded or last updated" /> <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." /> <requirements value="Allows determination of how current the summary is." /> <max value="1" /> <type> <code value="dateTime" /> </type> <isSummary value="true" /> <mapping> <identity value="w5" /> <map value="FiveWs.recorded" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=AUT].time" /> </mapping> </element> <element id="FamilyMemberHistory.name"> <path value="FamilyMemberHistory.name" /> <short value="The family member described" /> <definition value="This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair"." /> <requirements value="Allows greater ease in ensuring the same person is being talked about." /> <max value="1" /> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="name" /> </mapping> </element> <element id="FamilyMemberHistory.relationship"> <path value="FamilyMemberHistory.relationship" /> <short value="Relationship to the subject" /> <definition value="The type of relationship this person has to the patient (father, mother, brother etc.)." /> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FamilialRelationship" /> </extension> <strength value="example" /> <description value="The nature of the relationship between the patient and the related person being described in the family member history." /> <valueSet value="http://terminology.hl7.org/ValueSet/v3-FamilyMember" /> </binding> <mapping> <identity value="rim" /> <map value="code" /> </mapping> </element> <element id="FamilyMemberHistory.relationship.coding.code"> <path value="FamilyMemberHistory.relationship.coding.code" /> <definition value="BASE RESOURCE DEFINITION: A 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). CDS-S PROFILE DEFINITION: Relationship to the family member that is blood related to the patient." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE05.006" /> <comment value="Relationship" /> </mapping> </element> <element id="FamilyMemberHistory.sex"> <path value="FamilyMemberHistory.sex" /> <short value="male | female | other | unknown" /> <definition value="The birth sex of the family member." /> <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." /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Sex" /> </extension> <strength value="extensible" /> <description value="Codes describing the sex assigned at birth as documented on the birth registration." /> <valueSet value="http://build.fhir.org/valueset-administrative-gender.html" /> </binding> </element> <element id="FamilyMemberHistory.born[x]"> <path value="FamilyMemberHistory.born[x]" /> <short value="(approximate) date of birth" /> <definition value="The actual or approximate date of birth of the relative." /> <requirements value="Allows calculation of the relative's age." /> <max value="1" /> <type> <code value="Period" /> </type> <type> <code value="date" /> </type> <type> <code value="string" /> </type> <condition value="fhs-1" /> <mapping> <identity value="rim" /> <map value="player[classCode=LIV, determinerCode=INSTANCE]. birthDate (could be URG)" /> </mapping> </element> <element id="FamilyMemberHistory.age[x]"> <path value="FamilyMemberHistory.age[x]" /> <short value="(approximate) age" /> <definition value="The age of the relative at the time the family member history is recorded." /> <comment value="use estimatedAge to indicate whether the age is actual or not." /> <requirements value="While age can be calculated from date of birth, sometimes recording age directly is more natural for clinicians." /> <max value="1" /> <type> <code value="Age" /> </type> <type> <code value="Range" /> </type> <type> <code value="string" /> </type> <condition value="fhs-1" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ].act[classCode=OBS,moodCode=EVN, code="age"].value" /> </mapping> </element> <element id="FamilyMemberHistory.estimatedAge"> <path value="FamilyMemberHistory.estimatedAge" /> <short value="Age is estimated?" /> <definition value="If true, indicates that the age value specified is an estimated value." /> <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." /> <max value="1" /> <type> <code value="boolean" /> </type> <meaningWhenMissing value="It is unknown whether the age is an estimate or not" /> <condition value="fhs-2" /> <isSummary value="true" /> </element> <element id="FamilyMemberHistory.deceased[x]"> <path value="FamilyMemberHistory.deceased[x]" /> <short value="Dead? How old/when?" /> <definition value="Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record." /> <max value="1" /> <type> <code value="boolean" /> </type> <type> <code value="Age" /> </type> <type> <code value="Range" /> </type> <type> <code value="date" /> </type> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG) For age, you'd hang an observation off the role" /> </mapping> </element> <element id="FamilyMemberHistory.reasonCode"> <path value="FamilyMemberHistory.reasonCode" /> <short value="Why was family member history performed?" /> <definition value="Describes why the family member history occurred in coded or textual form." /> <comment value="Textual reasons can be captured using reasonCode.text." /> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FamilyHistoryReason" /> </extension> <strength value="example" /> <description value="Codes indicating why the family member history was done." /> <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings" /> </binding> <mapping> <identity value="workflow" /> <map value="Event.reasonCode" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.why[x]" /> </mapping> <mapping> <identity value="rim" /> <map value=".reasonCode" /> </mapping> </element> <element id="FamilyMemberHistory.reasonReference"> <path value="FamilyMemberHistory.reasonReference" /> <short value="Why was family member history performed?" /> <definition value="Indicates a Condition, Observation, AllergyIntolerance, or QuestionnaireResponse that justifies this family member history event." /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.reasonReference" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.why[x]" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=RSON].target" /> </mapping> </element> <element id="FamilyMemberHistory.note"> <path value="FamilyMemberHistory.note" /> <short value="General note about related person" /> <definition value="BASE RESOURCE 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. CDS-S PROFILE DEFINITION: Additional notes about family member history of a problem, diagnosis or procedure." /> <type> <code value="Annotation" /> </type> <mustSupport value="true" /> <mapping> <identity value="workflow" /> <map value="Event.note" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE05.007" /> <comment value="Notes" /> </mapping> </element> <element id="FamilyMemberHistory.condition"> <path value="FamilyMemberHistory.condition" /> <short value="Condition that the related person had" /> <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." /> <type> <code value="BackboneElement" /> </type> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]" /> </mapping> </element> <element id="FamilyMemberHistory.condition.code"> <path value="FamilyMemberHistory.condition.code" /> <short value="Condition suffered by relation" /> <definition value="BASE RESOURCE 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. CDS-S PROFILE DEFINITION: A description that identifies the family member's history of a problem diagnosis or procedure." /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConditionCode" /> </extension> <strength value="example" /> <description value="Identification of the Condition or diagnosis." /> <valueSet value="http://hl7.org/fhir/ValueSet/condition-code" /> </binding> <mapping> <identity value="rim" /> <map value=".value" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE05.004" /> <comment value="Problem/Diagnosis/Procedure" /> </mapping> </element> <element id="FamilyMemberHistory.condition.outcome"> <path value="FamilyMemberHistory.condition.outcome" /> <short value="deceased | permanent disability | etc." /> <definition value="Indicates what happened following the condition. If the condition resulted in death, deceased date is captured on the relation." /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConditionOutcome" /> </extension> <strength value="example" /> <description value="The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc." /> <valueSet value="http://hl7.org/fhir/ValueSet/condition-outcome" /> </binding> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value" /> </mapping> </element> <element id="FamilyMemberHistory.condition.contributedToDeath"> <path value="FamilyMemberHistory.condition.contributedToDeath" /> <short value="Whether the condition contributed to the cause of death" /> <definition value="This condition contributed to the cause of death of the related person. If contributedToDeath is not populated, then it is unknown." /> <max value="1" /> <type> <code value="boolean" /> </type> </element> <element id="FamilyMemberHistory.condition.onset[x]"> <path value="FamilyMemberHistory.condition.onset[x]" /> <short value="When condition first manifested" /> <definition value="BASE RESOURCE 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. CDS-S PROFILE DEFINITION (Start Date): The date when the family member was diagnosed or had symptoms of a disease or a problem, or had a procedure. CDS-S PROFILE DEFINITION (Age at Onset): The age of the family member at the onset of the condition. CDS-S PROFILE DEFINITION (Life Stage): The stage of life the family member is in at the onset of the condition. MUST SUPPORT: Age at Onset, Life Stage." /> <comment value="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. CODE SET TABLE: CT-016: Life Stage" /> <requirements value="Age of onset of a condition in relatives is predictive of risk for the patient." /> <max value="1" /> <type> <code value="Age" /> <profile value="https://simplifier.net/omd-cdss/onsetage" /> </type> <type> <code value="Range" /> </type> <type> <code value="Period" /> <profile value="https://simplifier.net/omd-cdss/onsetperiod" /> </type> <type> <code value="string" /> </type> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE05.001" /> <comment value="Start Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE05.002" /> <comment value="Age at Onset" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE05.003" /> <comment value="Life Stage" /> </mapping> <mapping> <identity value="rim" /> <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> <element id="FamilyMemberHistory.condition.note"> <path value="FamilyMemberHistory.condition.note" /> <short value="Extra information about condition" /> <definition value="BASE RESOURCE DEFINITION: An area where general notes can be placed about this specific condition. CDS-S PROFILE DEFINITION: Type or nature of the treatment delivered to the family member." /> <type> <code value="Annotation" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE05.005" /> <comment value="Treatment" /> </mapping> </element> </differential> </StructureDefinition>

Name	Flags	Card.	Type	Description & Constraints
FamilyMemberHistory	I TU		DomainResource	Information about patient's relatives, relevant for patient + Rule: Can have age[x] or born[x], but not both + Rule: Can only have estimatedAge if age[x] is present Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Id(s) for this record
instantiatesCanonical	Σ	0..*	canonical( PlanDefinition \| Questionnaire \| ActivityDefinition \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
status	?! Σ	1..1	code	partial \| completed \| entered-in-error \| health-unknown FamilyHistoryStatus ( Required)
dataAbsentReason	Σ	0..1	CodeableConcept	subject-unknown \| withheld \| unable-to-obtain \| deferred FamilyHistoryAbsentReason ( Example)
patient	Σ	1..1	Reference( Patient)	Patient history is about
date	Σ	0..1	dateTime	When history was recorded or last updated
name	Σ	0..1	string	The family member described
relationship	Σ	1..1	CodeableConcept	Relationship to the subject V3 Value SetFamilyMember ( Example)
sex	Σ	0..1	CodeableConcept	male \| female \| other \| unknown Sex ( Extensible)
born[x]	I	0..1		(approximate) date of birth
bornPeriod			Period
bornDate			date
bornString			string
age[x]	Σ I	0..1		(approximate) age
ageAge			Age
ageRange			Range
ageString			string
estimatedAge	Σ I	0..1	boolean	Age is estimated?
deceased[x]	Σ	0..1		Dead? How old/when?
deceasedBoolean			boolean
deceasedAge			Age
deceasedRange			Range
deceasedDate			date
deceasedString			string
reasonCode	Σ	0..*	CodeableConcept	Why was family member history performed? SNOMED CT Clinical Findings ( Example)
reasonReference	Σ	0..*	Reference( Condition \| Observation \| AllergyIntolerance \| QuestionnaireResponse \| DiagnosticReport \| DocumentReference)	Why was family member history performed?
note		0..*	Annotation	General note about related person
condition		0..*	BackboneElement	Condition that the related person had
code		1..1	CodeableConcept	Condition suffered by relation Condition/Problem/Diagnosis Codes ( Example)
outcome		0..1	CodeableConcept	deceased \| permanent disability \| etc. Condition Outcome Codes ( Example)
contributedToDeath		0..1	boolean	Whether the condition contributed to the cause of death
onset[x]		0..1		When condition first manifested
onsetAge			Age
onsetRange			Range
onsetPeriod			Period
onsetString			string
note		0..*	Annotation	Extra information about condition
Documentation for this format