ARCHETYPE Family history (openEHR-EHR-EVALUATION.family_history.v0)

ARCHETYPE IDopenEHR-EHR-EVALUATION.family_history.v0
ConceptFamily history
DescriptionSummary information about the significant health-related problems found in family members.
UseUse to record a summary of information about problems or diagnoses found in family members. This information may be used to contribute to an assessment of risk to the individual from potentially inheritable conditions or initiation of preventive health activities. Traditionally the scope of family history has been focused on genetic factors or biomarkers as indicators of risk or potential risk. However the scope of this archetype explicitly includes the recording of information about problems or diagnoses that may be influenced by familial exposure of non-genetic family members to psychosocial or environmental factors as well. Examples that are relevant for non-genetic family members include exposure to toxins in the family environment, domestic violence, sexual abuse, alcoholism and other addictions. Non-genetic family members can include adopted or long term fostered children, those related by marriage, or other unrelated individuals who participate in the regular life and influence of the family. This archetype has been designed to include: - a narrative overview as free text. This will allow family history details from existing systems to be incorporated as non-structured text; and - a detailed area focusing on relevant health details about specific family members, inlcuding their medical history and biomarkers. This archetype can be used within many contexts. For example, recording a family history entry within a clinical consultation; populating a Family History List; or to provide a summary statement within a Discharge Summary document. Additional detail about a family member's specific problem or diagnosis can be captured using the EVALUATION.problem_diagnosis archetype and specifying the 'Subject of Care' as the family member, rather than the subject of the health record. This archetype can be used as the basis for a Family Pedigree chart of health problems/diagnoses or to support estimations of risk of a condition based on prevalence in the family history or known biomarkers. It may be necessary to identify each family member specifically and not just by the relationship to the patient. For example, while there will be only one maternal grandmother, there may be many female maternal cousins. This may be required to ensure that a pedigree chart is accurate. It will also enable accurate amendments to the record for each identified family member. If the record is private and will not be shared, for reasons of clarity it may be preferable to record the relative's actual name. If the record, or part of the record, is to be shared, it may be more appropriate for the family member to be identified by a unique label or alias.
MisuseNot to be used to record information about the relative or absolute risk of developing a condition due to family history - use the EVALUATION.health_risk archetype, including the CLUSTER.family_prevalence for details about the affected ratio of family members. Not to be used for contact tracing for infectious diseases requiring immediate action. Not to be used to record an exclusion of Family History - use the EVALUATION.exclusion-family_history archetype for this purpose.
PurposeTo record information about the occurrence of significant health-related problems in genetic and non-genetic family members - both alive and deceased. The intended scope of this archetype is deliberately kept loose to include the broadest range of problems or issues that might be found within families. It specifically includes known problems and diagnoses, identified biological markers, plus any relevant psychosocial factors and environmental factors.
ReferencesFamily History, draft archetype [Internet]. Australia, National eHealth Transition Authority, NEHTA Clinical Knowledge Manager. Authored: 2010 12 15. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.927 (last accessed 2015 03 05).

Risk of condition based on family history, rejected archetype, openEHR Clinical Knowledge Manager [Internet]. openEHR Foundation. Authored: 2006 04 23. Available at: http://www.openehr.org/ckm/#showArchetype_1013.1.125 (last accessed 2015 03 05).

HL7 Version 3 Standard: Clinical Genomics; Pedigree, Release 1. ANSI/HL7 V3 CGPED, R1-2007. Published 2007 05 07. Available at: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=8 (last accessed 2015 03 05).

Family History FHIR resource [Internet]. Health Level Seven International. Available at: http://www.hl7.org/implement/standards/fhir/familyhistory.html (last accessed 2015 03 24).
Copyright© openEHR Foundation
AuthorsAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 2010-12-15
Other Details LanguageAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 2010-12-15
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=Ocean Informatics, references=Family History, draft archetype [Internet]. Australia, National eHealth Transition Authority, NEHTA Clinical Knowledge Manager. Authored: 2010 12 15. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.927 (last accessed 2015 03 05). Risk of condition based on family history, rejected archetype, openEHR Clinical Knowledge Manager [Internet]. openEHR Foundation. Authored: 2006 04 23. Available at: http://www.openehr.org/ckm/#showArchetype_1013.1.125 (last accessed 2015 03 05). HL7 Version 3 Standard: Clinical Genomics; Pedigree, Release 1. ANSI/HL7 V3 CGPED, R1-2007. Published 2007 05 07. Available at: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=8 (last accessed 2015 03 05). Family History FHIR resource [Internet]. Health Level Seven International. Available at: http://www.hl7.org/implement/standards/fhir/familyhistory.html (last accessed 2015 03 24)., current_contact=Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com, original_namespace=com.oceaninformatics, original_publisher=Ocean Informatics, custodian_namespace=com.oceaninformatics, MD5-CAM-1.0.1=3FE156D0134A97A303D35E1ADD7BC25E, build_uid=4a1cc8ec-ec98-464e-ab4b-72b51b2870b0, revision=0.0.1-alpha}
Keywordsfamily, history, health, condition, problem, diagnosis, genetic, pedigree, genealogy, family history, relative, hereditary, family history
Lifecyclein_development
UIDd4f81658-9caf-4a7e-9a61-78ef3585a207
Language useden
Citeable Identifier1013.1.863
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Summary information about the significant health-related problems found in family members., archetypeConceptComment=null, otherContributors=Tomas Alme, DIPS, Norway
Rita Apelt, Department of Health,NT, Australia
Vebjoern Arntzen, Oslo university hospital, Norway
Koray Atalag, University of Auckland, New Zealand
Silje Ljosland Bakke, Bergen Hospital Trust, Norway
John Bennett, NEHTA, Australia
Lars Bitsch-Larsen, Haukeland University hospital, Norway
Diego Bosca, IBIME group, Spain
Rong Chen, Cambio Healthcare Systems, Sweden
Stephen Chu, Queensland Health, Australia
David Evans, Queensland Health, Australia
Shahla Foozonkhah, Ocean Informatics, Australia
Einar Fosse, National Centre for Integrated Care and Telemedicine, Norway
Samuel Frade, Marand, Portugal
Tim Garden, NTG Department of Health, Australia
Sebastian Garde, Ocean Informatics, Germany
Jacquie Garton-Smith, Royal Perth Hospital and DoHWA, Australia
Andrew Goodchild, NEHTA, Australia
Sam Heard, Ocean Informatics, Australia (Editor)
Lars Karlsen, DIPS ASA, Norway
Mary Kelaher, NEHTA, Australia
Shinji Kobayashi, Kyoto University, Japan
Robert L'egan, NEHTA, Australia
Heather Leslie, Ocean Informatics, Australia (Editor)
Hugh Leslie, Ocean Informatics, Australia
Hallvard Lærum, Oslo University Hospital, Norway
Mike Martyn, The Hobart Anaesthetic Group, Australia
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor)
Chris Mitchell, RACGP, Australia
Stewart Morrison, NEHTA, Australia
Bjoern Naess, DIPS ASA, Norway
Jeremy Oats, NT Health, Australia
Lynne Parsons, Primary and Community Health Services, Australia
Jodie Pycroft, Adelaide Northern Division of General Practice Ltd, Australia
Robyn Richards, NEHTA - Clinical Terminology, Australia
Jussara Rotzsch, UNB, Brazil
Anoop Shah, University College London, United Kingdom
Elizabeth Stanick, Hobart Anaesthetic Group, Australia
John Taylor, NEHTA, Australia
Gordon Tomes, Australian Institute of Health and Welfare, Australia
Richard Townley-O'Neill, NEHTA, Australia
Donna Truran, ACCTI-UoW, Australia
Jo Wright, NT Dept of Health, Australia (Editor), originalLanguage=en, translators=Portuguese (Brazil): Vladimir Pizzo, Hospital Sirio Libanes - Brazil, vladimir.pizzo@hsl.org.br
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All not explicitly excluded archetypes, extendedValues=null]], content=[], state=[], description=[], identities=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Summary, description=Narrative overview about problems, diagnoses, psychosocial, environmental and genetic markers that have been identified in family members., comment=Use this field to capture unstructured family history information recorded in clinical records or to import textual data from existing/legacy clinical systems., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028], code=at0028, itemType=CLUSTER, level=2, text=Per problem, description=Details about the presence of a specific problem or diagnosis in family members., comment=If the problem has a genetic predisposition within families, then only genetic relatives should be considered as part of this data. If the problem has psychosocial or environmental effects then non-genetic family members may also be included., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0029], code=at0029, itemType=ELEMENT, level=3, text=Problem name, description=Identification of the problem or diagnosis, by name., comment=This is the problem for which aggregated data involving all family members will be collected. Coding of the index problem with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0036], code=at0036, itemType=ELEMENT, level=3, text=Present?, description=There is a positive family history of the index problem in one or more family members., comment=Record as 'True' if the problem or diagnosis has been identified in family members., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0030], code=at0030, itemType=ELEMENT, level=3, text=Description, description=Narrative description about occurrence of the problem or diagnosis in family members., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0059], code=at0059, itemType=SLOT, level=3, text=Family prevalence, description=Details about family prevalence of the identified problem or diagnosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
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openEHR-EHR-CLUSTER.person_name.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=3, text=Relationship, description=The relationship of the family member to the subject of care., comment=For example: mother, father, maternal grandmother, or paternal uncle. 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For example: environmental allergens triggering respiratory exaccerbations; or events such as Christmas., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008], code=at0008, itemType=CLUSTER, level=3, text=Medical history, description=Detail about problems or diagnoses for the family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0009], code=at0009, itemType=ELEMENT, level=4, text=Problem/diagnosis, description=Identification of the significant problem or diagnosis in the identified family member., comment=Coding of the family member's problem or diagnosis with a terminology is preferred, where possible. May link from this data element to a detailed record of a Problem/Diagnosis using the EVALUATION.problem_diagnosis archetype with the Subject of Care set to the family member, not to the patient., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0012], code=at0012, itemType=ELEMENT, level=4, text=Clinical description, description=Narrative description or comments about clinical aspects of the family member's problem/diagnosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Age at onset, description=Estimated or actual age of the family member when the problem/diagnosis was clinically recognised., comment=For health problems with multiple occurrences, this describes the first nown occurrence., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0014], code=at0014, itemType=ELEMENT, level=4, text=Cause of death?, description=True if the problem/diagnosis was a direct cause of death in this family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=3, text=Comment, description=Additional narrative about the family member not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024], code=at0024, itemType=CLUSTER, level=3, text=Biomarkers, description=Detailed information about measurable indicators of a biological state or condition of the subject of record., comment=For example: detailed information on BRCA mutations in family members. Note: More data elements will be needed in future to record detailed genetic marker information., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024]/items[at0022], code=at0022, itemType=ELEMENT, level=4, text=Biomarker description, description=Description of risk-related biological markers identified in this family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024]/items[at0027], code=at0027, itemType=SLOT, level=4, text=Biomarker details, description=Structured details about biological markers., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER and ELEMENT, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0053], code=at0053, itemType=SLOT, level=2, text=Multimedia, description=Mulitimedia representation of the family history., comment=For example: a pedigree chart., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
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