Name Flags Card. Type Description & Constraints doco
. . Condition I TU DomainResource Detailed information about conditions, problems or diagnoses
+ Rule: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error
+ Rule: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
+ Rule: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
. . . identifier Σ 0..* Identifier External Ids for this condition
. . . clinicalStatus ?! Σ I 0..1 CodeableConcept active | recurrence | relapse | well-controlled | poorly-controlled | inactive | remission | resolved
Condition Clinical Status Codes ( Required)
. . . verificationStatus ?! Σ I 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
ConditionVerificationStatus ( Required)
. . . category 0..* CodeableConcept problem-list-item | encounter-diagnosis
Condition Category Codes ( Example)
. . . severity 0..1 CodeableConcept Subjective severity of condition
Condition/Diagnosis Severity ( Preferred)
. . . code Σ 0..1 CodeableConcept Identification of the condition, problem or diagnosis
Condition/Problem/Diagnosis Codes ( Example)
. . . bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
SNOMED CT Body Structures ( Example)
. . . subject Σ 1..1 Reference( Patient | Group) Who has the condition?
. . . context Σ 0..1 Reference( Encounter | EpisodeOfCare) Encounter or episode when condition first asserted
. . . onset[x] Σ 0..1 Estimated or actual date, date-time, or age
. . . . onsetDateTime dateTime
. . . . onsetAge Age
. . . . onsetPeriod Period
. . . . onsetRange Range
. . . . onsetString string
. . . abatement[x] I 0..1 When in resolution/remission
. . . . abatementDateTime dateTime
. . . . abatementAge Age
. . . . abatementPeriod Period
. . . . abatementRange Range
. . . . abatementString string
. . . recordedDate Σ 0..1 dateTime Date record was first recorded
. . . recorder Σ 0..1 Reference( Practitioner | Patient | RelatedPerson) Who recorded the condition
. . . asserter Σ 0..1 Reference( Practitioner | PractitionerRole | Patient | RelatedPerson) Person who asserts this condition
. . . stage I 0..* BackboneElement Stage/grade, usually assessed formally
+ Rule: Stage SHALL have summary or assessment
. . . . summary I 0..1 CodeableConcept Simple summary (disease specific)
Condition Stage ( Example)
. . . . assessment I 0..* Reference( ClinicalImpression | DiagnosticReport | Observation) Formal record of assessment
. . . . type 0..1 CodeableConcept Kind of staging
Condition Stage Type ( Example)
. . . evidence I 0..* BackboneElement Supporting evidence
+ Rule: evidence SHALL have code or details
. . . . code Σ I 0..* CodeableConcept Manifestation/symptom
Manifestation and Symptom Codes ( Example)
. . . . detail Σ I 0..* Reference( Any) Supporting information found elsewhere
. . . note 0..* Annotation Additional information about the Condition

doco Documentation for this format