StructureDefinition: hspc-alteredmentalstatus - XML

hspc-alteredmentalstatus

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="hspc-alteredmentalstatus"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/hspc-alteredmentalstatus"/>
  <name value="HSPC Altered Mental Status Assertion"/>
  <status value="draft"/>
  <publisher value="HSPC"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://healthcaresoa.org"/>
    </telecom>
  </contact>
  <date value="2015-10-16"/>
  <description value="This is the HSPC specific profile for asserting a patient has an altered mental status"/>
  <fhirVersion value="1.4.0"/>
  <kind value="resource"/>
  <abstract value="false"/>
  <baseType value="Condition"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/hspc-clinicalassert"/>
  <derivation value="constraint"/>
  <snapshot>
    <element>
      <path value="Condition"/>
      <name value="hspc-alteredmentalstatus"/>
      <short value="Detailed information about conditions, problems or diagnoses"/>
      <definition value="Use to record detailed information about conditions, problems or diagnoses recognized
       by a clinician. There are many uses including: recording a diagnosis during an encounter;
       populating a problem list or a summary statement, such as a discharge summary."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Condition"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PPR message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value&lt;Diagnosis]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="Diagnosis, Active, Inactive or Resolved"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Condition.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Condition.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Condition.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Condition.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="Condition.extension"/>
      <name value="criticality"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/condition-criticality"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Indicates the potential impact of the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/qicore-condition-criticality"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qidam"/>
        <map value="ManifestedSymptom.criticality"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.extension"/>
      <name value="bodySiteInstance"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-bodysite"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Condition.extension"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionshistoryIndicator"/>
      </type>
    </element>
    <element>
      <path value="Condition.extension"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsassociatedPrecondition"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The pre-existing condtions that affect the assertion of the condition"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-associatedprecondition"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.modifierExtension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="Condition.modifierExtension"/>
      <name value="FocalSubject"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsfocalSubject"/>
      </type>
      <isModifier value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="The set of codes that describe the subject of an observation when not the patient of record"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-focalSubject"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.modifierExtension"/>
      <name value="Likelihood"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionslikelihood"/>
      </type>
      <isModifier value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="A set of codes that describe the level of certainty, if any, that the observation exists
         or procedure was done"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-likelihood"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.modifierExtension"/>
      <name value="RiskForIndicator"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsriskForIndicator"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="Condition.identifier"/>
      <short value="External Ids for this condition"/>
      <definition value="This records identifiers associated with this condition that are defined by business processes
       and/or used to refer to it when a direct URL reference to the resource itself is not appropriate
       (e.g. in CDA documents, or in written / printed documentation)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.patient"/>
      <short value="Who has the condition?"/>
      <definition value="Indicates the patient who the condition record is associated with."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.patient"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.encounter"/>
      <short value="Encounter when condition first asserted"/>
      <definition value="Encounter during which the condition was first asserted."/>
      <comments value="This record indicates the encounter this particular record is associated with.  In the
       case of a &quot;new&quot; diagnosis reflecting ongoing/revised information about the condition,
       this might be distinct from the first encounter in which the underlying condition was
       first &quot;known&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/qicore-encounter"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19 (+PV1-54)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.asserter"/>
      <short value="Person who asserts this condition"/>
      <definition value="Individual who is making the condition statement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.asserter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-provpract"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-7.1 identifier + REL-7.12 type code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.dateRecorded"/>
      <short value="When first entered"/>
      <definition value="A date, when  the Condition statement was documented."/>
      <comments value="The Date Recorded represents the date when this particular Condition record was created
       in the EHR, not the date of the most recent update in terms of when severity, abatement,
       etc. were specified.  The date of the last record modification can be retrieved from the
       resource metadata."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.dateRecorded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.code"/>
      <short value="Identification of the condition, problem or diagnosis"/>
      <definition value="Identification of the condition, problem or diagnosis."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="419284004"/>
          <display value="Altered mental status (finding)"/>
        </coding>
      </fixedCodeableConcept>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="The set of codes that describe the thing being asserted as existing in or for the individual"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-clinicalFinding"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.category"/>
      <short value="complaint | symptom | finding | diagnosis"/>
      <definition value="A category assigned to the condition."/>
      <comments value="The categorization is often highly contextual and may appear poorly differentiated or
       not very useful in other contexts."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="A category assigned to the condition."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.clinicalStatus"/>
      <short value="active | relapse | remission | resolved"/>
      <definition value="The clinical status of the condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.clinicalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="The set of codes that describe the state of the assertion"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-clinicalAssertStatus"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14 / DG1-6"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.verificationStatus"/>
      <short value="provisional | differential | confirmed | refuted | entered-in-error | unknown"/>
      <definition value="The verification status to support the clinical status of the condition."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.verificationStatus"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The verification status to support or decline the clinical status of the condition or
         diagnosis."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-ver-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-13"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.severity"/>
      <short value="Subjective severity of condition"/>
      <definition value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
      <comments value="Coding of the severity with a terminology is preferred, where possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.severity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-26 / ABS-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Can be pre/post-coordinated into value.  Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OB
        S, moodCode=EVN, code=&quot;severity&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="severity"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.onset[x]"/>
      <short value="Estimated or actual date,  date-time, or age"/>
      <definition value="Estimated or actual date or date-time  the condition began, in the opinion of the clinician."/>
      <comments value="Age is generally used when the patient reports an age at which the Condition began to
       occur."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.onset[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Age"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN,
         code=&quot;age at onset&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.init"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.abatementDateTime"/>
      <name value="Date of Resolution"/>
      <short value="If/when in resolution/remission"/>
      <definition value="The date or estimated date that the condition resolved or went into remission. This is
       called &quot;abatement&quot; because of the many overloaded connotations associated with
       &quot;remission&quot; or &quot;resolution&quot; - Conditions are never really resolved,
       but they can abate."/>
      <comments value="There is no explicit distinction between resolution and remission because in many cases
       the distinction is not clear. Age is generally used when the patient reports an age at
       which the Condition abated.  If there is no abatement element, it is unknown whether the
       condition has resolved or entered remission; applications and users should generally assume
       that the condition is still valid."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.abatement[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN,
         code=&quot;age at remission&quot;].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC
        , moodCode=EVN].status=completed"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="stop datetime"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage"/>
      <short value="Stage/grade, usually assessed formally"/>
      <definition value="Clinical stage or grade of a condition. May include formal severity assessments."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="con-1"/>
        <severity value="error"/>
        <human value="Stage SHALL have summary or assessment"/>
        <expression value="summary or assessment"/>
        <xpath value="exists(f:summary) or exists(f:assessment)"/>
      </constraint>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;stage/grade&quot
        ;]"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage.summary"/>
      <short value="Simple summary (disease specific)"/>
      <definition value="A simple summary of the stage such as &quot;Stage 3&quot;. The determination of the stage
       is disease-specific."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.summary"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-1"/>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes describing condition stages (e.g. Cancer stages)."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-stage"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.stage.assessment"/>
      <short value="Formal record of assessment"/>
      <definition value="Reference to a formal record of the evidence on which the staging assessment is based."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.stage.assessment"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <condition value="con-1"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence"/>
      <short value="Supporting evidence"/>
      <definition value="Supporting Evidence / manifestations that are the basis on which this condition is suspected
       or confirmed."/>
      <comments value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations
       or formal assessments, or both."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="con-2"/>
        <severity value="error"/>
        <human value="evidence SHALL have code or details"/>
        <expression value="code or detail"/>
        <xpath value="exists(f:code) or exists(f:detail)"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence.code"/>
      <short value="Manifestation/symptom"/>
      <definition value="A manifestation or symptom that led to the recording of this condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.evidence.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes that describe the manifestation or symptoms of a condition."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="[code=&quot;diagnosis&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.evidence.detail"/>
      <short value="Supporting information found elsewhere"/>
      <definition value="Links to other relevant information, including pathology reports."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.detail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.bodySite"/>
      <name value="BodyLocationPrecoordinated"/>
      <short value="Anatomical location, if relevant"/>
      <definition value="The anatomical location where this condition manifests itself."/>
      <comments value="May be a summary code, or a reference to a very precise definition of the location, or
       both."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Condition.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="A set of codes that describe pre-coordinated body locations"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-observation-bodysite-precoordinated"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetBodySiteCode"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="anatomical location site and laterality"/>
      </mapping>
    </element>
    <element>
      <path value="Condition.notes"/>
      <short value="Additional information about the Condition"/>
      <definition value="Additional information about the Condition. This is a general notes/comments entry  for
       description of the Condition, its diagnosis and prognosis."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.notes"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="NTE child of PRB"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;]
        .value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Condition"/>
      <name value="hspc-alteredmentalstatus"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Condition"/>
      </type>
    </element>
    <element>
      <path value="Condition.qicore-bodysite"/>
      <min value="0"/>
      <max value="0"/>
    </element>
    <element>
      <path value="Condition.extenstion"/>
      <name value="Alleviating Factor"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsalleviatingFactor"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The set of concepts that describe actions or items that limit, reduce, or remove an identified
         condition or problem"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-amsalleviatingfactors"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.extenstion"/>
      <name value="Exacerbating Factor"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsexacerbatingFactor"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The set of concepts that describe actions or items that increase or worsen an identified
         condition or problem."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-amsexacerbatingfactors"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.extenstion"/>
      <name value="Periodicity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsperiodicity"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The set of concepts that describe the frequency that a condition or problem occurs."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-amsperiodicity"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.extenstion"/>
      <name value="Associated Sign and Symptom"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionsassociatedSignAndSymptom"/>
      </type>
    </element>
    <element>
      <path value="Condition.extenstion"/>
      <name value="Course"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-extensionscourse"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <description value="The set of concepts tht describe the rate of change of a condition or problem as well
         as whether or not it is getting better or worse."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-course"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Condition.code"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="419284004"/>
          <display value="Altered mental status (finding)"/>
        </coding>
      </fixedCodeableConcept>
    </element>
    <element>
      <path value="Condition.abatementDate"/>
      <name value="Date of Resolution"/>
      <type>
        <code value="dateTime"/>
      </type>
    </element>
    <element>
      <path value="Condition.bodySite"/>
      <min value="0"/>
      <max value="0"/>
    </element>
  </differential>
</StructureDefinition>