FamilyMemberHistory resource group

A FamilyMemberHistory resource records a condition that one of the patient’s relatives has or had. Keeping family history apart from the patient’s own Conditions matters: “Mother has breast cancer” is a risk factor for the patient, not a diagnosis. The resource follows the FHIR R4 FamilyMemberHistory specification, and each field name below links to its R4 definition.

What becomes a FamilyMemberHistory

Note says	`relationship`	`condition[0].code`
”Mother has type 2 diabetes”	`MTH` mother	`44054006` Type 2 diabetes mellitus
”Father died of a myocardial infarction at 60”	`FTH` father	`22298006` Myocardial infarction, with `contributedToDeath: true`
”Maternal grandmother had breast cancer”	`MGRMTH` maternal grandmother	`254837009` Malignant neoplasm of breast

Each resource holds one relative and one condition. A relative with two conditions gives two resources.

Negative family history

Each resource records a condition that a relative has or had. The endpoint skips negative family history: “No family history of heart disease” produces no FamilyMemberHistory resource. The condition[0].code is a disorder in positive form, not a code such as 160303001 Family history of diabetes mellitus.

Fields

FHIR R4 has no top-level code on FamilyMemberHistory. The condition code sits in condition[0].code.

Field	Type	What it holds	Example from a note
`status`	code	`completed` by default. Also `partial`, `entered-in-error`, or `health-unknown`. See the R4 value set.
`relationship`	CodeableConcept	The relative, as an HL7 RoleCode and a SNOMED CT person concept. Free text when the endpoint does not recognize the relationship. R4 requires `relationship`: when the note does not say who the relative is, it is marked unknown with the data-absent-reason extension. See the R4 value set.	”older sister” → `SIS` sister
`name`	string	The relative’s name, when the note gives one
`sex`	CodeableConcept	`male`, `female`, `other`, or `unknown`, plus SNOMED CT for male and female. See the R4 value set.	”brother” → `male`
`ageString`	string	The relative’s age	”aged 82” → `"82"`
`deceasedString`	string	Whether, or when, the relative died	”died at 60” → `"at 60"`
`patient`	Reference	The Patient of the Bundle
`condition`	list	The condition, with `code` (SNOMED CT disorder), `outcome` (text), `contributedToDeath`, and `onset`
`condition[0].onsetAge`, `onsetRange`, `onsetPeriod`, or `onsetString`	Quantity, Range, Period, or string	When the relative got the condition	”diagnosed at age 45” → `onsetAge` 45 years. “In her 50s” → `onsetRange` 50 to 59 years.
`note`	list of Annotation	Extra context
`extension`	list of Extension	Mentions and alternatives. Alternatives use the field `condition.code`.

FamilyMemberHistory has no encounter reference and no bodySite.

Relationship carries two codings

relationship holds the HL7 RoleCode first and the SNOMED CT person concept second:

Relative	RoleCode	SNOMED CT
mother	`MTH`	`72705000` Mother
father	`FTH`	`66839005` Father
sister	`SIS`	`27733009` Sister
brother	`BRO`	`70924004` Brother
maternal grandmother	`MGRMTH`	`394859001` Maternal grandmother

Codes the endpoint can assign

The endpoint only searches a fixed part of each coding system for each field. A code outside that part never appears, and a filter can only narrow the part further, never widen it. Codes come from a fixed scope explains why.

Field	Coding system	Allowed codes	Example
`condition[0].code`	SNOMED CT	Semantic tag `disorder`	`22298006` Myocardial infarction
`relationship`	HL7 RoleCode, plus SNOMED CT	A fixed table of relatives, shown in Relationship carries two codings
`sex`	FHIR administrative gender, plus SNOMED CT	`male`, `female`, `other`, `unknown`. SNOMED CT only for `248153007` Male and `248152002` Female.

Only disorders qualify. “Mother has migraine” gives a resource, because migraine is a disorder. “Father gets chest pain” gives none, because chest pain is a finding.

Example

Father died of a myocardial infarction at 60.

Simplified
JSON

Field	Value
`relationship`	`FTH` father
`sex`	`male`
`deceasedString`	`at 60`
`condition[0].code`	`22298006` Myocardial infarction
`condition[0].contributedToDeath`	`true`

{
  "resourceType": "FamilyMemberHistory",
  "id": "5d9a0f2c-7e41-5c86-b3a7-0e8f6d2c1b94",
  "status": "completed",
  "patient": { "reference": "urn:uuid:b49ecda5-92db-5325-a7a9-f82c71500bad", "type": "Patient" },
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "code": "FTH",
        "display": "father"
      },
      {
        "system": "http://snomed.info/sct",
        "code": "66839005",
        "display": "Father"
      }
    ],
    "text": "father"
  },
  "sex": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/administrative-gender",
        "code": "male",
        "display": "Male"
      },
      {
        "system": "http://snomed.info/sct",
        "code": "248153007",
        "display": "Male"
      }
    ],
    "text": "Male"
  },
  "deceasedString": "at 60",
  "condition": [
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "22298006",
            "display": "Myocardial infarction"
          }
        ],
        "text": "Myocardial infarction"
      },
      "contributedToDeath": true
    }
  ]
}

Clinical Text Generation

Medical Coding

FHIR Extraction

Clinical Assistant

What becomes a FamilyMemberHistory

Negative family history

Fields

Relationship carries two codings

Codes the endpoint can assign

Example

Next steps

Condition resource group

FHIR Extraction quickstart

​What becomes a FamilyMemberHistory

​Negative family history

​Fields

​Relationship carries two codings

​Codes the endpoint can assign

​Example

​Next steps

Condition resource group

FHIR Extraction quickstart

What becomes a FamilyMemberHistory

Negative family history

Fields

Relationship carries two codings

Codes the endpoint can assign

Example

Next steps