R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

9.2.7 Resource Condition - Mappings

Patient Care Work GroupMaturity Level: N/ABallot Status: Informative Compartments: Encounter, Patient, Practitioner, RelatedPerson

Mappings:

FiveWs Pattern

Workflow Pattern

HL7 v2 Mapping

SNOMED CT Attribute Binding

SNOMED CT Concept Domain Binding

RIM Mapping

Mappings for the condition resource.

9.2.7.1 Mappings for FiveWs Pattern (http://hl7.org/fhir/fivews)

Condition
    identifierFiveWs.identifier
    clinicalStatusFiveWs.status
    verificationStatusFiveWs.status
    categoryFiveWs.class
    severityFiveWs.grade
    codeFiveWs.what[x]
    subjectFiveWs.subject[x]
    contextFiveWs.context
    onset[x]FiveWs.init
    abatement[x]FiveWs.done[x]
    assertedDateFiveWs.recorded
    recorderFiveWs.author
    asserterFiveWs.source
        codeFiveWs.why[x]
        detailFiveWs.why[x]

9.2.7.2 Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

ConditionEvent
    identifierEvent.identifier
    clinicalStatusEvent.status
    verificationStatusEvent.status
    codeEvent.code
    subjectEvent.subject
    contextEvent.context
    assertedDateEvent.occurrence[x]
    asserterEvent.performer.actor
        codeEvent.reasonCode
        detailEvent.reasonReference
    noteEvent.note

9.2.7.3 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

ConditionPPR message
    identifier
    clinicalStatusPRB-14
    verificationStatusPRB-13
    category'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
    severityPRB-26 / ABS-3
    codePRB-3
    bodySite
    subjectPID-3
    contextPV1-19 (+PV1-54)
    onset[x]PRB-16
    abatement[x]
    assertedDateREL-11
    recorder
    asserterREL-7.1 identifier + REL-7.12 type code
    stage
        summaryPRB-14
        assessment
        type
    evidence
        code
        detail
    noteNTE child of PRB

9.2.7.4 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct)

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
Condition
    identifier
    clinicalStatus
    verificationStatus408729009
    category
    severity246112005
    code246090004
    bodySite363698007
    subject
    context
    onset[x]
    abatement[x]
    assertedDate
    recorder
    asserter
    stage
        summary
        assessment
        type
    evidence
        code
        detail
    note

9.2.7.5 Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
Condition< 243796009 |Situation with explicit context|:
246090004 |Associated finding| =
((< 404684003 |Clinical finding| MINUS
<< 420134006 |Propensity to adverse reactions| MINUS
<< 473010000 |Hypersensitivity condition| MINUS
<< 79899007 |Drug interaction| MINUS
<< 69449002 |Drug action| MINUS
<< 441742003 |Evaluation finding| MINUS
<< 307824009 |Administrative status| MINUS
<< 385356007 |Tumor stage finding|) OR
< 272379006 |Event|)
    identifier
    clinicalStatus< 303105007 |Disease phases|
    verificationStatus< 410514004 |Finding context value|
    category< 404684003 |Clinical finding|
    severity< 272141005 |Severities|
    codecode 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS
<< 420134006 |Propensity to adverse reactions| MINUS
<< 473010000 |Hypersensitivity condition| MINUS
<< 79899007 |Drug interaction| MINUS
<< 69449002 |Drug action| MINUS
<< 441742003 |Evaluation finding| MINUS
<< 307824009 |Administrative status| MINUS
<< 385356007 |Tumor stage finding|)
OR < 413350009 |Finding with explicit context|
OR < 272379006 |Event|
    bodySite< 442083009 |Anatomical or acquired body structure|
    subject
    context
    onset[x]
    abatement[x]
    assertedDate
    recorder
    asserter
    stage
        summary< 254291000 |Staging and scales|
        assessment
        type
    evidence
        code< 404684003 |Clinical finding|
        detail
    note

9.2.7.6 Mappings for RIM Mapping (http://hl7.org/v3)

ConditionObservation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]
    identifier.id
    clinicalStatusObservation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
    verificationStatusObservation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
    category.code
    severityCan be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
    code.value
    bodySite.targetBodySiteCode
    subject.participation[typeCode=SBJ].role[classCode=PAT]
    context.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
    onset[x].effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value
    abatement[x].effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed
    assertedDate.participation[typeCode=AUT].time
    recorder.participation[typeCode=AUT].role
    asserter.participation[typeCode=INF].role
    stage./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]
        summary.value
        assessment.self
        type./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]
    evidence.outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]
        code[code="diagnosis"].value
        detail.self
    note.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value