> ## Documentation Index
> Fetch the complete documentation index at: https://docs.corti.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# FamilyMemberHistory resource group

> Learn how conditions in a patient's relatives become FHIR R4 FamilyMemberHistory resources, and which fields the Corti API fills

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](https://hl7.org/fhir/R4/familymemberhistory.html) 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`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.status) | [code](https://docs.corti.ai/fhir/datatypes.md#primitive-types) | `completed` by default. Also `partial`, `entered-in-error`, or `health-unknown`. See the [R4 value set](https://hl7.org/fhir/R4/valueset-history-status.html). | |
| [`relationship`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.relationship) | [CodeableConcept](https://docs.corti.ai/fhir/datatypes.md#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](https://hl7.org/fhir/R4/extension-data-absent-reason.html) extension. See the [R4 value set](https://hl7.org/fhir/R4/v3/FamilyMember/vs.html). | "older sister" → `SIS` sister |
| [`name`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.name) | [string](https://docs.corti.ai/fhir/datatypes.md#primitive-types) | The relative's name, when the note gives one | |
| [`sex`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.sex) | [CodeableConcept](https://docs.corti.ai/fhir/datatypes.md#codeableconcept) | `male`, `female`, `other`, or `unknown`, plus SNOMED CT for male and female. See the [R4 value set](https://hl7.org/fhir/R4/valueset-administrative-gender.html). | "brother" → `male` |
| [`ageString`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.age_x_) | [string](https://docs.corti.ai/fhir/datatypes.md#primitive-types) | The relative's age | "aged 82" → `"82"` |
| [`deceasedString`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.deceased_x_) | [string](https://docs.corti.ai/fhir/datatypes.md#primitive-types) | Whether, or when, the relative died | "died at 60" → `"at 60"` |
| [`patient`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.patient) | [Reference](https://docs.corti.ai/fhir/datatypes.md#reference) | The Patient of the Bundle | |
| [`condition`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.condition) | list | The condition, with `code` (SNOMED CT disorder), `outcome` (text), `contributedToDeath`, and `onset` | |
| [`condition[0].onsetAge`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.condition.onset_x_), `onsetRange`, `onsetPeriod`, or `onsetString` | [Quantity](https://docs.corti.ai/fhir/datatypes.md#quantity), [Range](https://docs.corti.ai/fhir/datatypes.md#range), [Period](https://docs.corti.ai/fhir/datatypes.md#period), or [string](https://docs.corti.ai/fhir/datatypes.md#primitive-types) | When the relative got the condition | "diagnosed at age 45" → `onsetAge` 45 years. "In her 50s" → `onsetRange` 50 to 59 years. |
| [`note`](https://hl7.org/fhir/R4/familymemberhistory-definitions.html#FamilyMemberHistory.note) | list of [Annotation](https://docs.corti.ai/fhir/datatypes.md#annotation) | Extra context | |
| [`extension`](https://hl7.org/fhir/R4/extensibility.html#Extension) | list of [Extension](https://docs.corti.ai/fhir/datatypes.md#extension) | [Mentions and alternatives](https://docs.corti.ai/fhir/how-it-works.md#every-value-points-back-to-the-note). 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](https://docs.corti.ai/fhir/filter-reference.md#how-filters-combine) can only narrow the part further, never widen it. [Codes come from a fixed scope](https://docs.corti.ai/fhir/how-it-works.md#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](#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

```text theme={null}
Father died of a myocardial infarction at 60.
```

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

> [tab] JSON
>
> ```json theme={null}
> {
>   "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
>     }
>   ]
> }
> ```

## Next steps

> [card] [Condition resource group](https://docs.corti.ai/fhir/resource-groups/condition.md)
>
> Learn how the patient's own diagnoses look in FHIR.

> [card] [FHIR Extraction quickstart](https://docs.corti.ai/fhir/quickstart.md)
>
> Send a note and read the full response.


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