# US Core FamilyMemberHistory Profile - US Core Implementation Guide v9.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Core FamilyMemberHistory Profile**

## Resource Profile: US Core FamilyMemberHistory Profile 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory | *Version*:9.0.0 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](changes-between-versions.md#us-core-maturity-levels): 2 | *Computable Name*:USCoreFamilyMemberHistoryProfile |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.2.42.71 | | |

 
The US Core FamilyMemberHistory Profile inherits from the FHIR [FamilyMemberHistory](https://hl7.org/fhir/R4/familymemberhistory.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the FamilyMemberHistory resource to record, search, and retrieve basic clinical information about a family member's health history that is relevant to a patient's care. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. 

**Example Usage Scenarios:**

The following are example usage scenarios for the US Core FamilyMemberHistory profile:

* Query for a family member's relevant health history
* [Record or update](us-core-roadmap.md#future-candidate-requirements-under-consideration) relevant health history for a family member

### Mandatory and Must Support Data Elements

The following data elements must always be present ([Mandatory](must-support.md) definition) or must be supported if the data is present in the sending system ([Must Support](must-support.md) definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The [Formal Views](#profile) below provides the formal summary, definitions, and terminology requirements.

**Each FamilyMemberHistory Must Have:**

1. a record status
1. a patient
1. a relationship to the patient

**Each FamilyMemberHistory Must Support:**

1. a condition that the related person had1

**Additional USCDI Requirements:**

These [Additional USCDI Requirements](must-support.md#additional-uscdi-requirements) elements are not Mandatory or Must Support but are required for ONC Health IT certification testing and are included in the formal definition of the profile and the FamilyMemberHistory examples.

1. a recorder2

1,2 see guidance below

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

* 1 USCDI's applicable vocabulary standards for Family Health History are SNOMED CT and ICD-10-CM. 
* When using ICD codes, only **non-header** ICD-10-CM codes **SHOULD** be used.
* The [US Core Condition Codes](ValueSet-us-core-condition-code.md) supports ICD-9-CM for historical purposes only.
 

* 2The profile element `US Core FamilyMemberHistory Recorder Extension` communicates the [individual level provenance](basic-provenance.md#individual-level-provenance) author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

The [US Core FamilyMemberHistory Recorder Extension](StructureDefinition-us-core-familymemberhistory-recorder.md) is used to record the individual provenance. It will be replaced by the FHIR R6 [Cross Version Extension](http://hl7.org/fhir/R4/versions.html#extensions) when FHIR R6 is published.

**Usages:**

* Examples for this Profile: [FamilyMemberHistory/familymemberhistory-example](FamilyMemberHistory-familymemberhistory-example.md)
* CapabilityStatements using this Profile: [US Core Client CapabilityStatement](CapabilityStatement-us-core-client.md) and [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/hl7.fhir.us.core|current/StructureDefinition/StructureDefinition-us-core-familymemberhistory.json)

**Changes since version 8.0.1:**

* New Content

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-core-familymemberhistory.csv), [Excel](StructureDefinition-us-core-familymemberhistory.xlsx), [Schematron](StructureDefinition-us-core-familymemberhistory.sch) 

### Notes:

-------

**Quick Start**  

-------

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md) for a complete list of supported RESTful interactions for this IG.

* See the [Scopes Format](scopes.md#scopes-format) section for a description of the SMART scopes syntax.
* See the [Search Syntax](general-guidance.md#search-syntax) section for a description of the US Core search syntax.
* See the [General Requirements](general-requirements.md) section for additional rules and expectations when a Server requires status parameters.
* See the [General Guidance](general-guidance.md) section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to family health history data **SHALL** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [resource level scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#scopes-for-requesting-clinical-data): `<patient|user|system>/FamilyMemberHistory.rs` [§](requirements.md#CONF-0909)

-------

#### Mandatory Search Parameters:

The following search parameters and search parameter combinations **SHALL** be supported:

1. **SHALL** support searching for all family member's relevant health history using the [patient](SearchParameter-us-core-familymemberhistory-patient.md) search parameter`GET [base]/FamilyMemberHistory?patient={Patient/}[id]`Example:
> 
1. GET [base]/FamilyMemberHistory?patient=Patient/1137192

**Implementation Notes**: Fetches a bundle of all US Core FamilyMemberHistory Profile resources for the specified patient ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference)).

#### Optional Search Parameters:

The following search parameters and search parameter combinations **SHOULD** be supported

1. **SHOULD** support searching for family member's condition for a patient (e.g., all family members with breast cancer) using the combination of the [patient](SearchParameter-us-core-familymemberhistory-patient.md) and [code](SearchParameter-us-core-familymemberhistory-code.md) search parameters`GET [base]/FamilyMemberHistory?patient={Patient/}[id]&code={system|}[search_code]`Example:
> 
1. GET [base]/FamilyMemberHistory?patient=Patient/1137192&code=http://snomed.info/sct|709044004

**Implementation Notes**: Fetches a bundle of all US Core FamilyMemberHistory Profile resources for the specified patient and condition ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-core-familymemberhistory",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 2
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cgp"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.2.42.71"
  }],
  "version" : "9.0.0",
  "name" : "USCoreFamilyMemberHistoryProfile",
  "title" : "US Core FamilyMemberHistory Profile",
  "status" : "active",
  "date" : "2025-09-28",
  "publisher" : "HL7 International / Cross-Group Projects",
  "contact" : [{
    "name" : "HL7 International / Cross-Group Projects",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cgp"
    },
    {
      "system" : "email",
      "value" : "cgp@lists.HL7.org"
    }]
  }],
  "description" : "The US Core FamilyMemberHistory Profile inherits from the FHIR [FamilyMemberHistory](https://hl7.org/fhir/R4/familymemberhistory.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the FamilyMemberHistory resource to record, search, and retrieve basic clinical information about a family member's health history that is relevant to a patient's care. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "FamilyMemberHistory",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "FamilyMemberHistory",
      "path" : "FamilyMemberHistory"
    },
    {
      "id" : "FamilyMemberHistory.extension",
      "path" : "FamilyMemberHistory.extension",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "url"
        }],
        "rules" : "open"
      }
    },
    {
      "id" : "FamilyMemberHistory.extension:recorder",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "FamilyMemberHistory.extension",
      "sliceName" : "recorder",
      "short" : "𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded family member's health history",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-familymemberhistory-recorder"]
      }],
      "mustSupport" : false
    },
    {
      "id" : "FamilyMemberHistory.status",
      "path" : "FamilyMemberHistory.status",
      "mustSupport" : true
    },
    {
      "id" : "FamilyMemberHistory.patient",
      "path" : "FamilyMemberHistory.patient",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "FamilyMemberHistory.relationship",
      "path" : "FamilyMemberHistory.relationship",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "description" : "Characterization of the familial relationship between two people.",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.19579"
      }
    },
    {
      "id" : "FamilyMemberHistory.condition",
      "path" : "FamilyMemberHistory.condition",
      "min" : 0,
      "max" : "*",
      "mustSupport" : true
    },
    {
      "id" : "FamilyMemberHistory.condition.code",
      "path" : "FamilyMemberHistory.condition.code",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "description" : "Value set to describe the actual problem experienced by the patient",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code"
      }
    }]
  }
}

```
