QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide - Downloaded Version 7.0.2 See the Directory of published versions

## Resource Profile: QICore Condition Problems Health Concerns

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns | Version: 7.0.2
Standards status: Trial-use | Maturity Level: 4 | Computable Name: QICoreConditionProblemsHealthConcerns

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

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:

- category: (QI) category codes
- code: (QI) Identification of the condition, problem or diagnosis
- category(us-core): problem-list-item | health-concern
- subject: (QI) Who has the condition?

QI Elements:

- clinicalStatus: (QI) active | recurrence | relapse | inactive | remission | resolved
- extension(assertedDate): (QI) Date the condition was first asserted
- recordedDate: (QI) Date record was first recorded
- abatement[x]: (QI) When in resolution/remission
- severity: (QI) Subjective severity of condition
- onset[x]: (QI) Estimated or actual date, date-time, or age
- verificationStatus: (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error

Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve
Usage

    define "Active Diabetes Conditions":
      [ConditionProblemsHealthConcerns: Diabetes] Condition
        where Condition.isActive()

See the patterns page for implementation and usage patterns.

### Examples

Conditions Health Concern Example

Usages:

- Refer to this Profile: QICore AdverseEvent, QICore Encounter, QICore ImagingStudy, QICore MedicationRequest... Show 2 more, QICore Procedure and QICore ServiceRequest
- Examples for this Profile: Condition/health-concern-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
meta | S Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (QI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient
Additional Bindings | Purpose
US Core Condition Codes | Current
subject | S Σ | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
onset[x] | S Σ | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] | S C | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate | S Σ | 0..1 | dateTime | (QI) Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📦4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📦4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📦7.0.0 | US Core v7.0
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📦7.0.0 | US Core v7.0
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-3 | best practice | Condition | Condition.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-4 | error | Condition | If 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-5 | error | Condition | Condition.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-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | If 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-4 | error | Condition | If 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-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses
meta | S | 0..1 | Meta | Metadata about the resource
lastUpdated | S | 0..1 | instant | When the resource last changed
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (QI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus |  | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved
verificationStatus |  | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition
code |  | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis
subject |  | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
onset[x] |  | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] |  | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | (QI) Date record was first recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate | S | 0..1 | dateTime | (QI) 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 | ?!S Σ C | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient
Additional Bindings | Purpose
US Core Condition Codes | Current
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] | S C | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate | S Σ | 0..1 | dateTime | (QI) 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 | C | 0..* | BackboneElement | Stage/grade, usually assessed formally Constraints: con-1
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 | C | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment | C | 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 | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Condition.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Condition.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📦4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📦4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📦7.0.0 | US Core v7.0
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📦7.0.0 | US Core v7.0
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | US Core Condition Codes | 📦7.0.0 | US Core v7.0
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Condition.stage.summary | Base | example | Condition Stage | 📦4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📦4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-2 | error | Condition.evidence | evidence SHALL have code or details | `code.exists() or detail.exists()`
con-3 | best practice | Condition | Condition.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-4 | error | Condition | If 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-5 | error | Condition | Condition.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-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | If 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-4 | error | Condition | If 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-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 1 element
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0-ballot

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.category

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
meta | S Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (QI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient
Additional Bindings | Purpose
US Core Condition Codes | Current
subject | S Σ | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
onset[x] | S Σ | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] | S C | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate | S Σ | 0..1 | dateTime | (QI) Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📦4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📦4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📦7.0.0 | US Core v7.0
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📦7.0.0 | US Core v7.0
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-3 | best practice | Condition | Condition.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-4 | error | Condition | If 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-5 | error | Condition | Condition.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-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | If 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-4 | error | Condition | If 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-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses
meta | S | 0..1 | Meta | Metadata about the resource
lastUpdated | S | 0..1 | instant | When the resource last changed
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (QI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus |  | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved
verificationStatus |  | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition
code |  | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis
subject |  | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
onset[x] |  | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] |  | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | (QI) Date record was first recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate | S | 0..1 | dateTime | (QI) 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 | ?!S Σ C | 0..1 | CodeableConcept | (QI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (QI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (QI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity |  | 0..1 | CodeableConcept | (QI) Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | (QI) Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient
Additional Bindings | Purpose
US Core Condition Codes | Current
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(QICore Patient | Group) | (QI) Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | (QI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
abatement[x] | S C | 0..1 |  | (QI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
recordedDate | S Σ | 0..1 | dateTime | (QI) 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 | C | 0..* | BackboneElement | Stage/grade, usually assessed formally Constraints: con-1
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 | C | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment | C | 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 | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Condition.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Condition.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📦4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📦4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📦4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📦7.0.0 | US Core v7.0
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📦7.0.0 | US Core v7.0
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | US Core Condition Codes | 📦7.0.0 | US Core v7.0
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Condition.stage.summary | Base | example | Condition Stage | 📦4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📦4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-2 | error | Condition.evidence | evidence SHALL have code or details | `code.exists() or detail.exists()`
con-3 | best practice | Condition | Condition.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-4 | error | Condition | If 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-5 | error | Condition | Condition.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-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | If 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-4 | error | Condition | If 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-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 1 element
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0-ballot

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.category

Maturity: 4

Other representations of profile: CSV, Excel, Schematron