The family history of a patient is the medical history of the members of that patient's family.

Therefore if a coded system such as Read is used to record family history of particular conditions, all the codes in the entire coding system must be available to be used in the family history.

The family history chapter 12... in the Read Code version 2 was an aberration probably largely due to the Government of the time making a series of rapid and foolish decisions on what they termed disease prevention. It is due for correction, and indeed Read version 3 now seems likely to use Family history of.. as a qualifier of any other code.

However Read is neither universal nor guaranteed to be introduced and in the short term the only system I have encountered which handles this correctly is Surgery Manager, which stores the family history terms in a separate data table, thus allowing selection of any Read term and its correct interpretation as being an item in the family history rather than the personal history.

Automatic FH

Other members of the patient's family commonly are or have been registered in the same Practice and have their medical records on the computer. Provided a system of linking families by genetic relationship is available the family history can be constructed automatically.

For each identified relative the condition can be qualified by the degree of relationship, in terms of percentage of shared genes, and applied to searches.

Confidentiality and linking families

No item inferred by the computer from another family member can be disclosed to the patient until they volunteer it. Items unconfirmed should therefore be dim or otherwise marked as background and should not be reported in insurance company reports - since these cannot be confidential from the pateint and no consent to release personal medical history of other family members will have been obtained by the company.

Linking to Other Programs

There are several genealogical programs available and a de facto standard (CEDCOM) has arisen. It is highly desirable that clinical systems should be able to produce and understand this format.