QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.1)

QI-Core Implementation Guide - This is the current published version.. See the Directory of published versions

D.4.1 StructureDefinition-qicore-condition

Introduction:

See the patterns page for implementation and usage patterns.

define "Absence of Cervix":
	[Condition : "Congenital absence of cervix (disorder)"] NoCervixBirth
		where Global."Normalize Onset"(NoCervixBirth.onset) starts before end of "Measurement Period"
      and NoCervixBirth.clinicalStatus ~ ToConcept(Global."active")

Examples:

Severe Burn Example Appendicitis Example

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition

Profile of Condition for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

This profile builds on USCoreCondition.

This profile was published on Wed Aug 22 00:00:00 UTC 2018 as a draft by Health Level Seven, Inc. - CQI WG.

Description of Profiles, Differentials, and Snapshots.

Summary

Mandatory: 2 elements
Must-Support: 13 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-dueTo I0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)What caused the Condition?
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example)
... condition-occurredFollowing I0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Precedent for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
Binding: ConditionPredecessorCodes (example)
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)
... severity SI0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: US Core Condition Code (extensible)
... bodySite SΣI0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣI1..1Reference(QICorePatient)Who has the condition?
... encounter SΣI0..1Reference(QICoreEncounter)Encounter created as part of
... onset[x] SΣI0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
... abatement[x] SI0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
... recordedDate SΣI0..1dateTimeDate record was first recorded
... recorder ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter ΣI0..1Reference(QICorePatient | QICorePractitioner | QICoreRelatedPerson)Person who asserts this condition
... stage SI0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary SI0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example)
.... assessment I0..*Reference(ClinicalImpression | QICoreDiagnosticReportLab | QICoreObservation)Formal record of assessment
.... type I0..1CodeableConceptKind of staging
Binding: ConditionStageType (example)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note I0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Summary

Mandatory: 2 elements
Must-Support: 13 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-dueTo I0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)What caused the Condition?
URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Binding: ConditionCauseCodes (example)
... condition-occurredFollowing I0..*CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)Precedent for this Condition
URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
Binding: ConditionPredecessorCodes (example)
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)
... severity SI0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: US Core Condition Code (extensible)
... bodySite SΣI0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣI1..1Reference(QICorePatient)Who has the condition?
... encounter SΣI0..1Reference(QICoreEncounter)Encounter created as part of
... onset[x] SΣI0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
... abatement[x] SI0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
... recordedDate SΣI0..1dateTimeDate record was first recorded
... recorder ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter ΣI0..1Reference(QICorePatient | QICorePractitioner | QICoreRelatedPerson)Person who asserts this condition
... stage SI0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary SI0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example)
.... assessment I0..*Reference(ClinicalImpression | QICoreDiagnosticReportLab | QICoreObservation)Formal record of assessment
.... type I0..1CodeableConceptKind of staging
Binding: ConditionStageType (example)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note I0..*AnnotationAdditional information about the Condition

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
Condition.languagepreferredCommonLanguages
Max Binding: AllLanguages
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleUSCoreConditionCategoryCodes
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.codeextensibleUSCoreConditionCode
Condition.bodySiteexampleSNOMEDCTBodyStructures
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
con-3ConditionCondition.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-4ConditionIf 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-5ConditionCondition.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-2ConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ConditionIf 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-4ConditionIf 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-5ConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ConditionA resource should have narrative for robust management
: text.`div`.exists()
us-core-1ConditionA code in Condition.category SHOULD be from US Core Condition Category Codes value set.
: where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()
ele-1Condition.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.extension:dueToAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.extension:dueToMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.extension:occurredFollowingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.extension:occurredFollowingMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.clinicalStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.verificationStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.onset[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.abatement[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.recordedDateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
con-1Condition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
ele-1Condition.stageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.stage.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.stage.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.stage.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.stage.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.stage.summaryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.stage.assessmentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.stage.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
con-2Condition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
ele-1Condition.evidenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.evidence.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.evidence.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.evidence.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Condition.evidence.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Condition.evidence.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.evidence.detailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Condition.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())