FHIR Release 3 (STU)
Clinical SummaryThis page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
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| Patient Care Work Group | Maturity Level: 3 | Trial Use | Compartments: Encounter, Patient, Practitioner, RelatedPerson |
A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.
Condition is one of the event resources in the FHIR workflow specification.
This resource is used to record detailed information about a condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern. The condition could be a point in time diagnosis in context of an encounter, it could be an item on the practitioner’s Problem List, or it could be a concern that doesn’t exist on the practitioner’s Problem List. Often times, a condition is about a clinician's assessment and assertion of a particular aspect of a patient's state of health. It can be used to record information about a disease/illness identified from application of clinical reasoning over the pathologic and pathophysiologic findings (diagnosis), or identification of health issues/situations that a practitioner considers harmful, potentially harmful and may be investigated and managed (problem), or other health issue/situation that may require ongoing monitoring and/or management (health issue/concern).
The condition resource may be used to record a certain health state of a patient which does not normally present a negative outcome, e.g. pregnancy. The condition resource may be used to record a condition following a procedure, such as the condition of Amputee-BKA following an amputation procedure.
While conditions are frequently a result of a clinician's assessment and assertion of a particular aspect of a patient's state of health, conditions can also be expressed by the patient, related person, or any care team member. A clinician may have a concern about a patient condition (e.g. anorexia) that the patient is not concerned about. Likewise, the patient may have a condition (e.g. hair loss) that does not rise to the level of importance such that it belongs on a practitioner’s Problem List.
For example, each of the following conditions could rise to the level of importance such that it belongs on a problem or concern list due to its direct or indirect impact on the patient’s health. These examples may also be represented using other resources, such as FamilyMemberHistory, Observation, or Procedure.
The condition resource may be referenced by other resources as "reasons" for an action (e.g. MedicationRequest, Procedure, ProcedureRequest, etc.)
This resource is not typically used to record information about subjective and objective information that might lead to the recording of a Condition resource. Such signs and symptoms are typically captured using the Observation resource; although in some cases a persistent symptom, e.g. fever, headache may be captured as a condition before a definitive diagnosis can be discerned by a clinician.
Use the Observation resource when a symptom is resolved without long term management, tracking, or when a symptom contributes to the establishment of a condition.
Use Condition when a symptom requires long term management, tracking, or is used as a proxy for a diagnosis or problem that is not yet determined.
When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, using Condition alone is not sufficient as the allergy or intolerance needs to be represented as an AllergyIntolerance to be actionable for decision support
This resource is referenced by AdverseEvent, Appointment, CarePlan, CareTeam, Claim, ClinicalImpression, Communication, CommunicationRequest, Encounter, EpisodeOfCare, ExplanationOfBenefit, FamilyMemberHistory, Goal, MedicationAdministration, MedicationRequest, MedicationStatement, Procedure, ProcedureRequest, ReferralRequest, RiskAssessment and VisionPrescription
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Condition | I | DomainResource | Detailed information about conditions, problems or diagnoses + If condition is abated, then clinicalStatus must be either inactive, resolved, or remission + Condition.clinicalStatus SHALL be present if verificationStatus is not 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 | ?!ΣI | 0..1 | code | active | recurrence | inactive | remission | resolved Condition Clinical Status Codes (Required) |
| verificationStatus | ?!ΣI | 0..1 | code | provisional | differential | confirmed | refuted | entered-in-error | unknown 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 | If/when in resolution/remission | |
| abatementDateTime | dateTime | |||
| abatementAge | Age | |||
| abatementBoolean | boolean | |||
| abatementPeriod | Period | |||
| abatementRange | Range | |||
| abatementString | string | |||
| assertedDate | Σ | 0..1 | dateTime | Date record was believed accurate |
| asserter | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Person who asserts this condition |
 stage | I | 0..1 | BackboneElement | Stage/grade, usually assessed formally + 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 |
| evidence | I | 0..* | BackboneElement | Supporting evidence + evidence SHALL have code or details |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Manifestation and Symptom Codes (Example) |
| detail | ΣI | 0..* | Reference(Any) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
UML Diagram (Legend)
XML Template
<Condition xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier External Ids for this condition --></identifier> <clinicalStatus value="[code]"/><!--
0..1 active | recurrence | inactive | remission | resolved --> <verificationStatus value="[code]"/><!--
JSON Template
{
"resourceType" : "Condition",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // External Ids for this condition
"clinicalStatus" : "<code>", // C? active | recurrence | inactive | remission | resolved
"verificationStatus" : "<code>", // C? provisional | differential | confirmed | refuted | entered-in-error | unknown
"category" : [{ CodeableConcept }], // problem-list-item | encounter-diagnosis
"severity" : { CodeableConcept }, // Subjective severity of condition
"code" : { CodeableConcept }, // Identification of the condition, problem or diagnosis
"bodySite" : [{ CodeableConcept }], // Anatomical location, if relevant
"subject" : { Reference(Patient|Group) }, // R! Who has the condition?
"context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode when condition first asserted
// onset[x]: Estimated or actual date, date-time, or age. One of these 5:
"onsetDateTime" : "<dateTime>",
"onsetAge" : { Age },
"onsetPeriod" : { Period },
"onsetRange" : { Range },
"onsetString" : "<string>",
// abatement[x]: If/when in resolution/remission. One of these 6:
"abatementDateTime" : "<dateTime>",
"abatementAge" : { Age },
"abatementBoolean" : <boolean>,
"abatementPeriod" : { Period },
"abatementRange" : { Range },
"abatementString" : "<string>",
"assertedDate" : "<dateTime>", // Date record was believed accurate
"asserter" : { Reference(Practitioner|Patient|RelatedPerson) }, // Person who asserts this condition
"stage" : { // Stage/grade, usually assessed formally
"summary" : { CodeableConcept }, // C? Simple summary (disease specific)
"assessment" : [{ Reference(ClinicalImpression|DiagnosticReport|Observation) }] // C? Formal record of assessment
},
"evidence" : [{ // Supporting evidence
"code" : [{ CodeableConcept }], // C? Manifestation/symptom
"detail" : [{ Reference(Any) }] // C? Supporting information found elsewhere
}],
"note" : [{ Annotation }] // Additional information about the Condition
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since DSTU2
| Condition | |
| Condition.clinicalStatus |
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| Condition.verificationStatus |
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| Condition.category |
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| Condition.code |
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| Condition.subject |
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| Condition.context |
|
| Condition.onset[x] |
|
| Condition.abatement[x] |
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| Condition.assertedDate |
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| Condition.asserter |
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| Condition.evidence.code |
|
| Condition.note |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R2 <--> R3 Conversion Maps (status = 14 tests that all execute ok. 11 fail round-trip testing and 14 r3 resources are invalid (14 errors).).
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | DomainResource | Detailed information about conditions, problems or diagnoses + If condition is abated, then clinicalStatus must be either inactive, resolved, or remission + Condition.clinicalStatus SHALL be present if verificationStatus is not 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 | ?!ΣI | 0..1 | code | active | recurrence | inactive | remission | resolved Condition Clinical Status Codes (Required) |
| verificationStatus | ?!ΣI | 0..1 | code | provisional | differential | confirmed | refuted | entered-in-error | unknown 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 | If/when in resolution/remission | |
| abatementDateTime | dateTime | |||
| abatementAge | Age | |||
| abatementBoolean | boolean | |||
| abatementPeriod | Period | |||
| abatementRange | Range | |||
| abatementString | string | |||
| assertedDate | Σ | 0..1 | dateTime | Date record was believed accurate |
| asserter | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Person who asserts this condition |
| stage | I | 0..1 | BackboneElement | Stage/grade, usually assessed formally + 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 |
| evidence | I | 0..* | BackboneElement | Supporting evidence + evidence SHALL have code or details |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Manifestation and Symptom Codes (Example) |
| detail | ΣI | 0..* | Reference(Any) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
XML Template
<Condition xmlns="http://hl7.org/fhir">
JSON Template
{
"resourceType" : "Condition",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // External Ids for this condition
"clinicalStatus" : "<code>", // C? active | recurrence | inactive | remission | resolved
"verificationStatus" : "<code>", // C? provisional | differential | confirmed | refuted | entered-in-error | unknown
"category" : [{ CodeableConcept }], // problem-list-item | encounter-diagnosis
"severity" : { CodeableConcept }, // Subjective severity of condition
"code" : { CodeableConcept }, // Identification of the condition, problem or diagnosis
"bodySite" : [{ CodeableConcept }], // Anatomical location, if relevant
"subject" : { Reference(Patient|Group) }, // R! Who has the condition?
"context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode when condition first asserted
// onset[x]: Estimated or actual date, date-time, or age. One of these 5:
"onsetDateTime" : "<dateTime>",
"onsetAge" : { Age },
"onsetPeriod" : { Period },
"onsetRange" : { Range },
"onsetString" : "<string>",
// abatement[x]: If/when in resolution/remission. One of these 6:
"abatementDateTime" : "<dateTime>",
"abatementAge" : { Age },
"abatementBoolean" : <boolean>,
"abatementPeriod" : { Period },
"abatementRange" : { Range },
"abatementString" : "<string>",
"assertedDate" : "<dateTime>", // Date record was believed accurate
"asserter" : { Reference(Practitioner|Patient|RelatedPerson) }, // Person who asserts this condition
"stage" : { // Stage/grade, usually assessed formally
"summary" : { CodeableConcept }, // C? Simple summary (disease specific)
"assessment" : [{ Reference(ClinicalImpression|DiagnosticReport|Observation) }] // C? Formal record of assessment
},
"evidence" : [{ // Supporting evidence
"code" : [{ CodeableConcept }], // C? Manifestation/symptom
"detail" : [{ Reference(Any) }] // C? Supporting information found elsewhere
}],
"note" : [{ Annotation }] // Additional information about the Condition
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since DSTU2
| Condition | |
| Condition.clinicalStatus |
|
| Condition.verificationStatus |
|
| Condition.category |
|
| Condition.code |
|
| Condition.subject |
|
| Condition.context |
|
| Condition.onset[x] |
|
| Condition.abatement[x] |
|
| Condition.assertedDate |
|
| Condition.asserter |
|
| Condition.evidence.code |
|
| Condition.note |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R2 <--> R3 Conversion Maps (status = 14 tests that all execute ok. 11 fail round-trip testing and 14 r3 resources are invalid (14 errors).).
Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)
| Path | Definition | Type | Reference |
|---|---|---|---|
| Condition.clinicalStatus | The clinical status of the condition or diagnosis. | Required | Condition Clinical Status Codes |
| Condition.verificationStatus | The verification status to support or decline the clinical status of the condition or diagnosis. | Required | ConditionVerificationStatus |
| Condition.category | A category assigned to the condition. | Example | Condition Category Codes |
| Condition.severity | A subjective assessment of the severity of the condition as evaluated by the clinician. | Preferred | Condition/Diagnosis Severity |
| Condition.code | Identification of the condition or diagnosis. | Example | Condition/Problem/Diagnosis Codes |
| Condition.bodySite | Codes describing anatomical locations. May include laterality. | Example | SNOMED CT Body Structures |
| Condition.stage.summary | Codes describing condition stages (e.g. Cancer stages). | Example | Condition Stage |
| Condition.evidence.code | Codes that describe the manifestation or symptoms of a condition. | Example | Manifestation and Symptom Codes |
on Condition.stage: summary.exists() or assessment.exists()) on Condition.evidence: code.exists() or detail.exists()): verificationStatus='entered-in-error' or clinicalStatus.exists()): abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')Many of the code systems used for coding conditions will provide codes that define not only the condition itself, but may also specify a particular stage, location, or causality as part of the code. This is particularly true if SNOMED CT is used for the condition, and especially if expressions are allowed.
The Condition.code may also include such concepts as "history of X" and "good health", where it is useful or appropriate to make such assertions. It can also be used to capture "risk of" and "fear of", in addition to physical conditions, as well as "no known problems" or "negated" conditions (e.g., "no X" or "no history of X" - see the following section for "No Known Problems" and Negated Conditions).
When the Condition.code specifies additional properties of the condition, the other properties are not given a value - instead, the value must be understood from the Condition.code.
Conditions/Problems Not Reviewed, Not Asked
When a sending system does not have any information about conditions/problems being reviewed or the statement is about conditions/problems not yet being asked, then the List resource should be used to indicate the List.emptyReason.code="notasked".
Conditions/Problems Reviewed, None Identified
Systems may use the List.emptyReason when a statement is about the full scope of the list (i.e. the patient has no conditions/problems of any type). However, it may be preferred to use a code for "no known problems" (e.g., SNOMED CT: 160245001 |No current problems or disability (situation)|), so that all condition/problem data will be available and queryable from Condition resource instances.
Also note that care should be used when adding new Condition resources to a list to ensure that any negation statements that are voided by the addition of a new record are removed from the list. E.g. If the list contains a "no known problems" record and you add a "diabetes" condition record, then be sure that you remove the "no known problems" record.
STU Note: There are two primary ways of reporting "no known problems" in the current specification: using the CodeableConcept, as described above, or using the List resource with emptyReason. During the STU period, feedback
Provide feedback here
Patient Denies Condition
When the patient denies a condition, that can be annotated in the Condition.note element.
Generally, electronic records do not contain assertions of conditions that a patient does not have. There are however two exceptions:
The Condition.evidence provides the basis for whatever is present in Condition.code.
A range is used to communicate age period of subject at time of abatement.
If the data enterer is different from the asserter and needs to be known, this could be captured using a Provenance instance pointing to the Condition. For example, it is possible that a nurse records the condition on behalf of a physician. The physician is taking responsibility, despite the nurse entering it into the medical record.
The Condition.stage and Condition.clinicalStatus may have interdependencies. For example, some "stages" of cancer, etc. will be different for a remission than for the initial occurrence.
A known issue exists with circular references between Condition and ClinicalImpression, which is due to the low maturity level of ClinicalImpression. The Patient Care work group intends to address this issue when ClinicalImpression is considered substantially complete and ready for implementation.
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Expression | In Common |
| abatement-age | quantity | Abatement as age or age range | Condition.abatement.as(Age) | Condition.abatement.as(Range) | Condition.abatement.as(Age) | |
| abatement-boolean | token | Abatement boolean (boolean is true or non-boolean values are present) | Condition.abatement.as(boolean) | Condition.abatement.is(dateTime) | Condition.abatement.is(Age) | Condition.abatement.is(Period) | Condition.abatement.is(Range) | Condition.abatement.is(string) | |
| abatement-date | date | Date-related abatements (dateTime and period) | Condition.abatement.as(dateTime) | Condition.abatement.as(Period) | |
| abatement-string | string | Abatement as a string | Condition.abatement.as(string) | |
| asserted-date | date | Date record was believed accurate | Condition.assertedDate | |
| asserter | reference | Person who asserts this condition | Condition.asserter (Practitioner, Patient, RelatedPerson) | |
| body-site | token | Anatomical location, if relevant | Condition.bodySite | |
| category | token | The category of the condition | Condition.category | |
| clinical-status | token | The clinical status of the condition | Condition.clinicalStatus | |
| code | token | Code for the condition | Condition.code | 8 Resources |
| context | reference | Encounter or episode when condition first asserted | Condition.context (EpisodeOfCare, Encounter) | |
| encounter | reference | Encounter when condition first asserted | Condition.context (Encounter) | |
| evidence | token | Manifestation/symptom | Condition.evidence.code | |
| evidence-detail | reference | Supporting information found elsewhere | Condition.evidence.detail (Any) | |
| identifier | token | A unique identifier of the condition record | Condition.identifier | 26 Resources |
| onset-age | quantity | Onsets as age or age range | Condition.onset.as(Age) | Condition.onset.as(Range) | |
| onset-date | date | Date related onsets (dateTime and Period) | Condition.onset.as(dateTime) | Condition.onset.as(Period) | |
| onset-info | string | Onsets as a string | Condition.onset.as(string) | |
| patient | reference | Who has the condition? | Condition.subject (Patient) | 31 Resources |
| severity | token | The severity of the condition | Condition.severity | |
| stage | token | Simple summary (disease specific) | Condition.stage.summary | |
| subject | reference | Who has the condition? | Condition.subject (Group, Patient) | |
| verification-status | token | provisional | differential | confirmed | refuted | entered-in-error | unknown | Condition.verificationStatus |
®© HL7.org 2011+. FHIR Release 3 (STU; v3.0.2-11200) generated on Thurs, Oct 24, 2019 11:53+1100. QA Page
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