This page is part of the US Core (v4.1.0: STU5 Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions
Defining URL: | http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition |
Version: | 4.1.0 |
Name: | USCoreCondition |
Title: | US Core Condition Profile |
Status: | Active as of 6/27/20 |
Definition: | Defines constraints and extensions on the Condition resource for the minimal set of data to query and retrieve problems and health concerns information. |
Publisher: | HL7 International - Cross-Group Projects |
Copyright: | Used by permission of HL7 International, all rights reserved Creative Commons License |
Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition
This profile sets minimum expectations for the Condition resource to record, search, and fetch a list of conditions associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.
Example Usage Scenarios:
The following are example usage scenarios for the US Core Condition profile:
The following data-elements must always be present (Mandatory definition]) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.
Each Condition must have:
*The status element has the following constraints: SHALL be present if verification status is not entered-in-error and SHALL NOT be present if verification Status is entered-in-error.
Each Condition must support:
*See the next section for how the date of diagnosis is represented in this Profile.
Profile specific implementation guidance:
encounter-diagnosis
. An example search is shown in the Quick Start section below.
Condition.category
is “encounter-diagnosis” the encounter, SHOULD be referenced in Condition.encounter
.Condition.onsetDate
, or Condition.recordedDate
.
Condition.recordedDate
.Condition.onsetDate
. A server may support both, which means they support all 3 locations.Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Condition
Summary
Mandatory: 2 elements
Must-Support: 11 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
This structure is derived from Condition
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | I | 0..* | Condition | Detailed information about conditions, problems or diagnoses us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. |
condition-assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) |
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) |
Slices for category | SI | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis | health-concern Slice: Unordered, Open by pattern:$this |
category:us-core | S | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (required) |
code | S | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Code (extensible): Valueset to describe the actual problem experienced by the patient |
subject | S | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of |
onset[x] | S | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime S | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
abatement[x] | S | 0..1 | When in resolution/remission | |
abatementDateTime | dateTime S | |||
abatementAge | Age | |||
abatementPeriod | Period | |||
abatementRange | Range | |||
abatementString | string | |||
recordedDate | S | 0..1 | dateTime | Date record was first recorded |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | I | 0..* | Condition | Detailed information about conditions, problems or diagnoses us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
condition-assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | Σ | 0..* | Identifier | External Ids for this condition |
clinicalStatus | ?!SΣI | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) |
verificationStatus | ?!SΣI | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) |
Slices for category | SI | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis | health-concern Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. |
category:us-core | S | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (required) |
severity | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician. | |
code | SΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Code (extensible): Valueset to describe the actual problem experienced by the patient |
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
encounter | SΣ | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of |
onset[x] | SΣ | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime S | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
abatement[x] | SI | 0..1 | When in resolution/remission | |
abatementDateTime | dateTime S | |||
abatementAge | Age | |||
abatementPeriod | Period | |||
abatementRange | Range | |||
abatementString | string | |||
recordedDate | SΣ | 0..1 | dateTime | Date record was first recorded |
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | 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 con-1: Stage SHALL have summary or assessment |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages). |
assessment | I | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment |
type | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological). | |
evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition. |
detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
note | 0..* | Annotation | Additional information about the Condition | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | I | 0..* | Condition | Detailed information about conditions, problems or diagnoses us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. |
condition-assertedDate | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate | |
clinicalStatus | ?!ΣI | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) |
verificationStatus | ?!ΣI | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) |
Slices for category | I | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis | health-concern Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. |
category:us-core | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (required) | |
code | Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Code (extensible): Valueset to describe the actual problem experienced by the patient |
subject | Σ | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
encounter | Σ | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of |
onset[x] | Σ | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime | |||
abatement[x] | I | 0..1 | When in resolution/remission | |
abatementDateTime | dateTime | |||
recordedDate | Σ | 0..1 | dateTime | Date record was first recorded |
Documentation for this format |
This structure is derived from Condition
Summary
Mandatory: 2 elements
Must-Support: 11 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Condition
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | I | 0..* | Condition | Detailed information about conditions, problems or diagnoses us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. |
condition-assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) |
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) |
Slices for category | SI | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis | health-concern Slice: Unordered, Open by pattern:$this |
category:us-core | S | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (required) |
code | S | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Code (extensible): Valueset to describe the actual problem experienced by the patient |
subject | S | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of |
onset[x] | S | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime S | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
abatement[x] | S | 0..1 | When in resolution/remission | |
abatementDateTime | dateTime S | |||
abatementAge | Age | |||
abatementPeriod | Period | |||
abatementRange | Range | |||
abatementString | string | |||
recordedDate | S | 0..1 | dateTime | Date record was first recorded |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | I | 0..* | Condition | Detailed information about conditions, problems or diagnoses us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
condition-assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | Σ | 0..* | Identifier | External Ids for this condition |
clinicalStatus | ?!SΣI | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) |
verificationStatus | ?!SΣI | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) |
Slices for category | SI | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis | health-concern Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. |
category:us-core | S | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (required) |
severity | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician. | |
code | SΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Code (extensible): Valueset to describe the actual problem experienced by the patient |
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
encounter | SΣ | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of |
onset[x] | SΣ | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime S | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
abatement[x] | SI | 0..1 | When in resolution/remission | |
abatementDateTime | dateTime S | |||
abatementAge | Age | |||
abatementPeriod | Period | |||
abatementRange | Range | |||
abatementString | string | |||
recordedDate | SΣ | 0..1 | dateTime | Date record was first recorded |
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | 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 con-1: Stage SHALL have summary or assessment |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages). |
assessment | I | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment |
type | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological). | |
evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition. |
detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
note | 0..* | Annotation | Additional information about the Condition | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet |
Condition.language | preferred | CommonLanguages Max Binding: AllLanguages |
Condition.clinicalStatus | required | ConditionClinicalStatusCodes |
Condition.verificationStatus | required | ConditionVerificationStatus |
Condition.category | extensible | ConditionCategoryCodes |
Condition.category:us-core | required | USCoreConditionCategoryCodes |
Condition.severity | preferred | Condition/DiagnosisSeverity |
Condition.code | extensible | USCoreConditionCode |
Condition.bodySite | example | SNOMEDCTBodyStructures |
Condition.stage.summary | example | ConditionStage |
Condition.stage.type | example | ConditionStageType |
Condition.evidence.code | example | ManifestationAndSymptomCodes |
Id | Path | Details | Requirements |
us-core-1 | Condition | A code in Condition.category SHOULD be from US Core Condition Category Codes value set. : where(category.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category')).exists() | |
con-1 | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() | |
con-2 | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |
Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.
The following search parameters and search parameter combinations SHALL be supported:
SHALL support searching for all conditions including problems, health concerns, and encounter diagnosis for a patient using the patient
search parameter:
GET [base]/Condition?patient={Type/}[id]
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient (how to search by reference)
The following search parameter combinations SHOULD be supported:
SHOULD support searching using the combination of the patient
and clinical-status
search parameters:
GET [base]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and all "active" statuses (active,relapse,remission). This will not return any "entered in error" resources because of the conditional presence of the clinicalStatus element. (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient
and category
search parameters:
GET [base]/Condition?patient={Type/}[id]&category={system|}[code]
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and category. (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient
and category
and encounter
search parameters:
GET [base]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and category and encounter. When category = "encounter-diagnosis" will return the encounter diagnosis for the encounter. (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient
and code
search parameters:
GET [base]/Condition?patient={Type/}[id]&code={system|}[code]
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and code. (how to search by reference and how to search by token)
patient
and onset-date
search parameters:
onset-date
comparators: gt,lt,ge,le
onset-date
(e.g.onset-date=[date]&onset-date=[date]]&...
)GET [base]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)
patient
and asserted-date
search parameters:
asserted-date
comparators: gt,lt,ge,le
asserted-date
(e.g.asserted-date=[date]&asserted-date=[date]]&...
)GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)
patient
and recorded-date
search parameters:
recorded-date
comparators: gt,lt,ge,le
recorded-date
(e.g.recorded-date=[date]&recorded-date=[date]]&...
)GET [base]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)
patient
and abatement-date
search parameters:
abatement-date
comparators: gt,lt,ge,le
abatement-date
(e.g.abatement-date=[date]&abatement-date=[date]]&...
)GET [base]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)