MCC eCare Plan Implementation Guide
1.0.0-ballot - Comment only US

This page is part of the MCC eCare Plan Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: Multiple Chronic Condition Care Plan Chronic Disease Conditions

Official URL: http://hl7.org/fhir/us/mcc/StructureDefinition/MCCChronicDisease Version: 1.0.0-ballot
Draft as of 2020-06-29 Computable Name: MCCChronicDisease

This profile constrains US Core Condition Problems and Health Concerns Profile to encourage its use for chronic disease conditions for use in the MCC FHIR Care Plan or other FHIR Care Plans by linkages or references to goals and other resources..

This profile sets additional expectations for the US Core Condition Problems and Health Concerns Profile to record, search, and fetch condition or diagnosis terms representing chronic disease conditions or health concern, including information about a Social Determinants of Health-related conditions. associated with a patient. In addition to the requirements set in the US Core Condition Problems and Health Concerns profile, this derived profile is designed to add requirements to the following elements:

  • Condition.extension:resource-pertainsToGoal (Must Support)
  • Condition.evidence (Must Support): supporting evidence for the diagnosis
  • The profile leverages the “Condition-Due To’’ extension (Optional)
  • Staging: This profile adds no contraints on the Condition.stage element, but some of the MCC Condition value sets that are made up of staging terms may be used at Condition.stage. Care must be taken that the staging codes used do not conflict with the codes used at Condition.code that may contain precoordinated diagnoses terms that include a stage.

See the MCC Care Plan SDOH Guidance page for more information when exchanging Social Determinants of Health (SDOH) Problems/Health Concerns.

Comments are welcome with respect to the pragmatic use of the “Must Support” rules defined on these elements.

This profile can be bound with any of the value sets found MCC Condition Value Sets to query for, fetch or record particular condition of interest as described in the scope of each condition value set.

Profile Relationship Diagram example: Chronic Kidney Disease

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Condition-dueTo 0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Causes for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.


... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... onset[x] S0..1dateTime S, Age, Period, Range, stringEstimated or actual date, date-time, or age
... recordedDate S0..1dateTimeDate record was first recorded
... evidence S0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... detail 0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... clinicalStatus ?!SΣC0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S1..*CodeableConceptcategory codes
Slice: Unordered, Open by pattern:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


.... category:us-core S1..*CodeableConceptproblem-list-item | health-concern
Binding: US Core Problem or Health Concern (required)
.... category:sdoh S0..1CodeableConceptproblem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: sdoh
... code SΣ1..1CodeableConceptPlease see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient

... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
... abatement[x] SC0..1When in resolution/remission
.... abatementDateTimedateTime
... recordedDate SΣ0..1dateTimeDate record was first recorded
... evidence SC0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... detail ΣC0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleConditionCategoryCodes
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
Condition.category:sdohextensiblePattern: sdoh
Condition.codeextensibleUSCoreConditionCodes

Constraints

IdGradePath(s)DetailsRequirements
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
: clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... Condition-dueTo 0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Causes for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.


... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣC0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S1..*CodeableConceptcategory codes
Slice: Unordered, Open by pattern:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


.... category:us-core S1..*CodeableConceptproblem-list-item | health-concern
Binding: US Core Problem or Health Concern (required)
.... category:sdoh S0..1CodeableConceptproblem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.



Required Pattern: At least the following
..... id0..1idUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: sdoh
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣ1..1CodeableConceptPlease see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient

... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime S
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] SC0..1When in resolution/remission
.... abatementDateTimedateTime S
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate SΣ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage C0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary C0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence SC0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣC0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Condition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleConditionCategoryCodes
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
Condition.category:sdohextensiblePattern: sdoh
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.codeextensibleUSCoreConditionCodes
Condition.bodySiteexampleSNOMEDCTBodyStructures
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Must-Support: 4 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Condition.evidence.detail is sliced based on the value of profile:resolve()

Differential View

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Condition-dueTo 0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Causes for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.


... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... onset[x] S0..1dateTime S, Age, Period, Range, stringEstimated or actual date, date-time, or age
... recordedDate S0..1dateTimeDate record was first recorded
... evidence S0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... detail 0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... clinicalStatus ?!SΣC0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S1..*CodeableConceptcategory codes
Slice: Unordered, Open by pattern:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


.... category:us-core S1..*CodeableConceptproblem-list-item | health-concern
Binding: US Core Problem or Health Concern (required)
.... category:sdoh S0..1CodeableConceptproblem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: sdoh
... code SΣ1..1CodeableConceptPlease see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient

... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
... abatement[x] SC0..1When in resolution/remission
.... abatementDateTimedateTime
... recordedDate SΣ0..1dateTimeDate record was first recorded
... evidence SC0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... detail ΣC0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleConditionCategoryCodes
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
Condition.category:sdohextensiblePattern: sdoh
Condition.codeextensibleUSCoreConditionCodes

Constraints

IdGradePath(s)DetailsRequirements
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
: clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C0..*USCoreConditionProblemsHealthConcernsProfileDetailed information about conditions, problems or diagnoses
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... Condition-dueTo 0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Causes for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.


... resource-pertainsToGoal S0..*Reference(Goal)The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣC0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S1..*CodeableConceptcategory codes
Slice: Unordered, Open by pattern:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


.... category:us-core S1..*CodeableConceptproblem-list-item | health-concern
Binding: US Core Problem or Health Concern (required)
.... category:sdoh S0..1CodeableConceptproblem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.



Required Pattern: At least the following
..... id0..1idUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1idUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: sdoh
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣ1..1CodeableConceptPlease see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient

... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime S
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] SC0..1When in resolution/remission
.... abatementDateTimedateTime S
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate SΣ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage C0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary C0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence SC0..*BackboneElementSupporting evidence for the presence of a chronic condition should be provided whenever possible.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣC0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC0..*Reference(Resource)Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged.
Slice: Unordered, Open by profile:resolve()
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Condition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleConditionCategoryCodes
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
Condition.category:sdohextensiblePattern: sdoh
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.codeextensibleUSCoreConditionCodes
Condition.bodySiteexampleSNOMEDCTBodyStructures
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Must-Support: 4 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Condition.evidence.detail is sliced based on the value of profile:resolve()

 

Other representations of profile: CSV, Excel, Schematron