Stream: implementers
Topic: FamilyMemberHistory Identifier
Tushar Nair (Aug 15 2020 at 00:32):
Hello,
In CCDA/FamilyHistory Template we get an id for the subject which typically represents an identifier for the FamilyMember. Is there an equivalent element in FamilyMemberHistory resource in FHIR?
Lloyd McKenzie (Aug 23 2020 at 23:21):
FamilyMemberHistory.identifier?
Richard Kavanagh (Aug 25 2020 at 10:23):
@Tushar Nair From what i can see the answer is no - for the "FamilyMember" there is the provision to carry a relationship and a name - but no identifier.
Lloyd McKenzie (Aug 25 2020 at 13:35):
How is this not FamilyMemberHistory.identifier?
Vassil Peytchev (Aug 25 2020 at 13:56):
Isn't the identifier for the history record? That's what it says in Requirements: Allows identification of the family member history. It seems that a link to Person might be a better way to have an obvious identifier for the family member, and not the history record.
Lloyd McKenzie (Aug 25 2020 at 15:19):
Person is a linkage resource for Patient, RelatedPerson and Practitioner. Nothing is allowed to point to it directly.
Lloyd McKenzie (Aug 25 2020 at 15:19):
Generally, a given family member would only have one FamilyMemberHistory instance
Lloyd McKenzie (Aug 25 2020 at 15:20):
So the identifier should correspond to a single individual. (If you had multiple CDA documents, the identifier there could be different too.)
Vassil Peytchev (Aug 25 2020 at 16:03):
So the identifier should correspond to a single individual. (If you had multiple CDA documents, the identifier there could be different too.)
In the C-CDA case you have subject/relatedSubject@class="PRS"/subject/id. The identifier is on the Person level, not on the history level. If the source of the multiple C-CDA is the same, the identifier should be the same. If the source of the CCDA is different, there is a chance that there is a common identifier, e.g. a driver's license, on the person level.
I think that without a special guidance, FamilyMemberHistory.identifier is unlikely to match what is in the CCDA. A link from FamilyMemberHistory to RelatedPerson is probably a better match.
Benjamin Flessner (Aug 25 2020 at 16:10):
It seems that all of the demographics fields and the relationship field in FamilyMemberHistory would be better represented by a required reference to RelatedPerson. Or a choice between RelatedPerson and a BackboneElement of FamilyMemberDemographics (with an added identifier field).
Lloyd McKenzie (Aug 25 2020 at 17:41):
A RelatedPerson is someone who's expected to take action on a Patient's behalf - which is unlikely to be Great Aunt Sue who died 30 years ago. If you're wanting to tie a FamilyMemberHistory to the Patient record associated with that relative, there's an extension for that.
Last updated: Apr 12 2022 at 19:14 UTC
