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Family Member History Profile

Canonical../StructureDefinition/nexus-emr-core-familymemberhistory
Statusdraft (experimental) · 1.26.0
BaseFamilyMemberHistory (constraint)
SourceFSH · JSON

Nexus EMR profile for FamilyMemberHistory -- family history as discrete chart content for summaries and extraction output. First pass: one relative, coded relationship, condition list with onset. Closed to SMART apps pending an exposure decision.

Overview

Overview

The Nexus EMR Core FamilyMemberHistory profile carries family history as discrete, queryable chart content rather than as prose. Family history is one of the patient-summary domains a summary loads, and clinical extraction produces family-history findings, so extraction output needs a contract to be written against: this profile is that contract.

This is a first pass covering one relative with a coded relationship and a list of that relative's conditions. Richer age and estimated-age representation, genetic-pedigree modelling, and the reconciliation with the free-text family-history block that heritage charts carry are all deliberately unsettled. The profile is closed to SMART apps pending an exposure decision.

One resource per relative

The shape is deliberately narrow:

  • patient (1..1, only Reference(NexusEmrCorePatient)) -- whose family history this is, never the relative.
  • relationship (1..1) -- who the relative is. Bound extensible to http://terminology.hl7.org/ValueSet/v3-FamilyMember; codes come from the v3 RoleCode system (MTH, FTH, SIB, ...). Extensible rather than required because heritage charts carry local relationship wording, which belongs in relationship.text alongside the coding.
  • condition (0..*) -- the conditions the relative had. Each entry requires condition.code (1..1); text is required for readability and coding is optional, the same posture as Condition.code on this IG's Condition profile.
  • condition.onset[x] (0..1) -- typically onsetAge ("diagnosed at 52") rather than a date, since family history is usually reported relative to the relative's age.

Because condition is 0..*, a conformant instance can record a relative with no conditions at all. Read that as "recorded, nothing to report", not as incomplete data.

status distinguishes "nothing known" from "nothing there"

status is 1..1 and takes partial | completed | entered-in-error | health-unknown. The two easy to conflate are health-unknown and completed with an empty condition list: the first says the relative's health is not known to the patient, the second says it is known and unremarkable. A consumer rendering a family-history block should say something different in each case.

date (0..1) is when the history was recorded or last updated, and is this profile's declared effective date. A resource without it will not sort by date onto a chart timeline, so populate it whenever the source records it.

See FamilyMemberHistory/nexus-emr-familymemberhistory-example for a worked instance.

Terminology bindings

Path Strength Value set
FamilyMemberHistory.relationship extensible v3-FamilyMember