Release 5 Draft Ballot

This page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot - see ballot notes). 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 Resource Condition - Content

Patient Care Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner, RelatedPerson

This resource has been identified by it's owning workgroup as a normative candidate for R5. Ballot comment is requested on this.

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

9.2.1 Scope and Usage

Condition is one of the event resources in the FHIR workflow specification.

This resource is used to record detailed information about a condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern. The condition could be a point in time diagnosis in context of an encounter, it could be an item on the practitioner’s Problem List, or it could be a concern that doesn’t exist on the practitioner’s Problem List. Often times, a condition is about a clinician's assessment and assertion of a particular aspect of a patient's state of health. It can be used to record information about a disease/illness identified from application of clinical reasoning over the pathologic and pathophysiologic findings (diagnosis), or identification of health issues/situations that a practitioner considers harmful, potentially harmful and may be investigated and managed (problem), or other health issue/situation that may require ongoing monitoring and/or management (health issue/concern).

The condition resource may be used to record a certain health state of a patient which does not normally present a negative outcome, e.g. pregnancy. The condition resource may be used to record a condition following a procedure, such as the condition of Amputee-BKA following an amputation procedure.

While conditions are frequently a result of a clinician's assessment and assertion of a particular aspect of a patient's state of health, conditions can also be expressed by the patient, related person, or any care team member. A clinician may have a concern about a patient condition (e.g. anorexia) that the patient is not concerned about. Likewise, the patient may have a condition (e.g. hair loss) that does not rise to the level of importance such that it belongs on a practitioner’s Problem List.

For example, each of the following conditions could rise to the level of importance such that it belongs on a problem or concern list due to its direct or indirect impact on the patient’s health. These examples may also be represented using other resources, such as FamilyMemberHistory, Observation, RiskAssessment, or Procedure.

  • Unemployed
  • Without transportation (or other barriers)
  • Susceptibility to falls
  • Exposure to communicable disease
  • Family History of cardiovascular disease
  • Fear of cancer
  • Cardiac pacemaker
  • Amputee-BKA
  • Risk of Zika virus following travel to a country
  • Former smoker
  • Travel to a country planned (that warrants immunizations)
  • Motor Vehicle Accident
  • Patient has had coronary bypass graft

9.2.2 Boundaries and Relationships

The condition resource may be referenced by other resources as "reasons" for an action (e.g. MedicationRequest, Procedure, ServiceRequest, etc.)

This resource is not typically used to record information about subjective and objective information that might lead to the recording of a Condition resource. Such signs and symptoms are typically captured using the Observation resource; although in some cases a persistent symptom, e.g. fever, headache may be captured as a condition before a definitive diagnosis can be discerned by a clinician. By contrast, headache may be captured as an Observation when it contributes to the establishment of a meningitis Condition.

Use the Observation resource when a symptom is resolved without long term management, tracking, or when a symptom contributes to the establishment of a condition.

Use Condition when a symptom requires long term management, tracking, or is used as a proxy for a diagnosis or problem that is not yet determined.

When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

9.2.3 References

This resource is referenced by AdverseEvent, Claim, ClinicalImpression, CoverageEligibilityRequest, Encounter, EpisodeOfCare, ExplanationOfBenefit, Goal, Procedure and RiskAssessment.

This resource implements the Event pattern.

9.2.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition TUDomainResourceDetailed information about conditions, problems or diagnoses
+ Warning: If category is problems list item, the clinicalStatus should not be unknown
+ Rule: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission.
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!ΣI1..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Condition Clinical Status Codes (Required)
... verificationStatus ?!Σ0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
ConditionVerificationStatus (Required)
... severity 0..1CodeableConceptSubjective severity of condition
Condition/Diagnosis Severity (Preferred)
... code Σ0..1CodeableConceptIdentification of the condition, problem or diagnosis
Condition/Problem/Diagnosis Codes (Example)
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
SNOMED CT Body Structures (Example)
... subject Σ1..1Reference(Patient | Group)Who has the condition?
... encounter Σ0..1Reference(Encounter)The Encounter during which this Condition was created
... onset[x] Σ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate Σ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device)Person or device that asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
+ Rule: Stage SHALL have summary or assessment
.... summary I0..1CodeableConceptSimple summary (disease specific)
Condition Stage (Example)
.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Condition Stage Type (Example)
... evidence I0..*BackboneElementSupporting evidence for the verification status
+ Rule: evidence SHALL have code or details
.... code ΣI0..*CodeableConceptManifestation/symptom
Manifestation and Symptom Codes (Example)
.... detail ΣI0..*Reference(Any)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

UML Diagram (Legend)

Condition (DomainResource)Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The clinical status of the condition (this element modifies the meaning of other elements)clinicalStatus : CodeableConcept [1..1] « null (Strength=Required) ConditionClinicalStatusCodes! »The verification status to support the clinical status of the condition. The verification status pertains to the condition, itself, not to any specific condition attribute (this element modifies the meaning of other elements)verificationStatus : CodeableConcept [0..1] « null (Strength=Required) ConditionVerificationStatus! »A category assigned to the conditioncategory : CodeableConcept [0..*] « null (Strength=Preferred)ConditionCategoryCodes? »A subjective assessment of the severity of the condition as evaluated by the clinicianseverity : CodeableConcept [0..1] « null (Strength=Preferred)Condition/DiagnosisSeverity? »Identification of the condition, problem or diagnosiscode : CodeableConcept [0..1] « null (Strength=Example)Condition/Problem/DiagnosisCo...?? »The anatomical location where this condition manifests itselfbodySite : CodeableConcept [0..*] « Codes describing anatomical locations. May include laterality. (Strength=Example)SNOMEDCTBodyStructures?? »Indicates the patient or group who the condition record is associated withsubject : Reference [1..1] « Patient|Group »The Encounter during which this Condition was created or to which the creation of this record is tightly associatedencounter : Reference [0..1] « Encounter »Estimated or actual date or date-time the condition began, in the opinion of the clinicianonset[x] : DataType [0..1] « dateTime|Age|Period|Range|string »The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Some conditions, such as chronic conditions, are never really resolved, but they can abateabatement[x] : DataType [0..1] « dateTime|Age|Period|Range|string »The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated daterecordedDate : dateTime [0..1]Individual who recorded the record and takes responsibility for its contentrecorder : Reference [0..1] « Practitioner|PractitionerRole|Patient| RelatedPerson »Individual or device that is making the condition statementasserter : Reference [0..1] « Practitioner|PractitionerRole|Patient| RelatedPerson|Device »Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosisnote : Annotation [0..*]StageA simple summary of the stage such as "Stage 3" or "Early Onset". The determination of the stage is disease-specific, such as cancer, retinopathy of prematurity, kidney diseases, Alzheimer's, or Parkinson diseasesummary : CodeableConcept [0..1] « null (Strength=Example)ConditionStage?? »Reference to a formal record of the evidence on which the staging assessment is basedassessment : Reference [0..*] « ClinicalImpression|DiagnosticReport| Observation »The kind of staging, such as pathological or clinical stagingtype : CodeableConcept [0..1] « null (Strength=Example)ConditionStageType?? »EvidenceA manifestation or symptom that led to the recording of this conditioncode : CodeableConcept [0..*] « null (Strength=Example)ManifestationAndSymptomCodes?? »Links to other relevant information, including pathology reportsdetail : Reference [0..*] « Any »A simple summary of the stage such as "Stage 3" or "Early Onset". The determination of the stage is disease-specific, such as cancer, retinopathy of prematurity, kidney diseases, Alzheimer's, or Parkinson diseasestage[0..*]Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the conditionevidence[0..*]

XML Template

<Condition xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this condition --></identifier>
 <clinicalStatus><!-- ?? 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved --></clinicalStatus>
 <verificationStatus><!-- 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error --></verificationStatus>
 <category><!-- ?? 0..* CodeableConcept problem-list-item | encounter-diagnosis --></category>
 <severity><!-- 0..1 CodeableConcept Subjective severity of condition --></severity>
 <code><!-- 0..1 CodeableConcept Identification of the condition, problem or diagnosis --></code>
 <bodySite><!-- 0..* CodeableConcept Anatomical location, if relevant --></bodySite>
 <subject><!-- 1..1 Reference(Group|Patient) Who has the condition? --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this Condition was created --></encounter>
 <onset[x]><!-- 0..1 dateTime|Age|Period|Range|string Estimated or actual date,  date-time, or age --></onset[x]>
 <abatement[x]><!-- ?? 0..1 dateTime|Age|Period|Range|string When in resolution/remission --></abatement[x]>
 <recordedDate value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <recorder><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the condition --></recorder>
 <asserter><!-- 0..1 Reference(Device|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Person or device that asserts this condition --></asserter>
 <stage>  <!-- 0..* Stage/grade, usually assessed formally -->
  <summary><!-- ?? 0..1 CodeableConcept Simple summary (disease specific) --></summary>
  <assessment><!-- ?? 0..* Reference(ClinicalImpression|DiagnosticReport|Observation) Formal record of assessment --></assessment>
  <type><!-- 0..1 CodeableConcept Kind of staging --></type>
 </stage>
 <evidence>  <!-- 0..* Supporting evidence for the verification status -->
  <code><!-- ?? 0..* CodeableConcept Manifestation/symptom --></code>
  <detail><!-- ?? 0..* Reference(Any) Supporting information found elsewhere --></detail>
 </evidence>
 <note><!-- 0..* Annotation Additional information about the Condition --></note>
</Condition>

JSON Template

{doco
  "resourceType" : "Condition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this condition
  "clinicalStatus" : { CodeableConcept }, // C? R!  active | recurrence | relapse | inactive | remission | resolved
  "verificationStatus" : { CodeableConcept }, // unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
  "category" : [{ CodeableConcept }], // C? problem-list-item | encounter-diagnosis
  "severity" : { CodeableConcept }, // Subjective severity of condition
  "code" : { CodeableConcept }, // Identification of the condition, problem or diagnosis
  "bodySite" : [{ CodeableConcept }], // Anatomical location, if relevant
  "subject" : { Reference(Group|Patient) }, // R!  Who has the condition?
  "encounter" : { Reference(Encounter) }, // The Encounter during which this Condition was created
  // onset[x]: Estimated or actual date,  date-time, or age. One of these 5:
  "onsetDateTime" : "<dateTime>",
  "onsetAge" : { Age },
  "onsetPeriod" : { Period },
  "onsetRange" : { Range },
  "onsetString" : "<string>",
  // abatement[x]: When in resolution/remission. One of these 5:
  "abatementDateTime" : "<dateTime>",
  "abatementAge" : { Age },
  "abatementPeriod" : { Period },
  "abatementRange" : { Range },
  "abatementString" : "<string>",
  "recordedDate" : "<dateTime>", // Date record was first recorded
  "recorder" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the condition
  "asserter" : { Reference(Device|Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Person or device that asserts this condition
  "stage" : [{ // Stage/grade, usually assessed formally
    "summary" : { CodeableConcept }, // C? Simple summary (disease specific)
    "assessment" : [{ Reference(ClinicalImpression|DiagnosticReport|Observation) }], // C? Formal record of assessment
    "type" : { CodeableConcept } // Kind of staging
  }],
  "evidence" : [{ // Supporting evidence for the verification status
    "code" : [{ CodeableConcept }], // C? Manifestation/symptom
    "detail" : [{ Reference(Any) }] // C? Supporting information found elsewhere
  }],
  "note" : [{ Annotation }] // Additional information about the Condition
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Condition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Condition.identifier [ Identifier ], ... ; # 0..* External Ids for this condition
  fhir:Condition.clinicalStatus [ CodeableConcept ]; # 1..1 active | recurrence | relapse | inactive | remission | resolved
  fhir:Condition.verificationStatus [ CodeableConcept ]; # 0..1 unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
  fhir:Condition.category [ CodeableConcept ], ... ; # 0..* problem-list-item | encounter-diagnosis
  fhir:Condition.severity [ CodeableConcept ]; # 0..1 Subjective severity of condition
  fhir:Condition.code [ CodeableConcept ]; # 0..1 Identification of the condition, problem or diagnosis
  fhir:Condition.bodySite [ CodeableConcept ], ... ; # 0..* Anatomical location, if relevant
  fhir:Condition.subject [ Reference(Group|Patient) ]; # 1..1 Who has the condition?
  fhir:Condition.encounter [ Reference(Encounter) ]; # 0..1 The Encounter during which this Condition was created
  # Condition.onset[x] : 0..1 Estimated or actual date,  date-time, or age. One of these 5
    fhir:Condition.onsetDateTime [ dateTime ]
    fhir:Condition.onsetAge [ Age ]
    fhir:Condition.onsetPeriod [ Period ]
    fhir:Condition.onsetRange [ Range ]
    fhir:Condition.onsetString [ string ]
  # Condition.abatement[x] : 0..1 When in resolution/remission. One of these 5
    fhir:Condition.abatementDateTime [ dateTime ]
    fhir:Condition.abatementAge [ Age ]
    fhir:Condition.abatementPeriod [ Period ]
    fhir:Condition.abatementRange [ Range ]
    fhir:Condition.abatementString [ string ]
  fhir:Condition.recordedDate [ dateTime ]; # 0..1 Date record was first recorded
  fhir:Condition.recorder [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who recorded the condition
  fhir:Condition.asserter [ Reference(Device|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Person or device that asserts this condition
  fhir:Condition.stage [ # 0..* Stage/grade, usually assessed formally
    fhir:Condition.stage.summary [ CodeableConcept ]; # 0..1 Simple summary (disease specific)
    fhir:Condition.stage.assessment [ Reference(ClinicalImpression|DiagnosticReport|Observation) ], ... ; # 0..* Formal record of assessment
    fhir:Condition.stage.type [ CodeableConcept ]; # 0..1 Kind of staging
  ], ...;
  fhir:Condition.evidence [ # 0..* Supporting evidence for the verification status
    fhir:Condition.evidence.code [ CodeableConcept ], ... ; # 0..* Manifestation/symptom
    fhir:Condition.evidence.detail [ Reference(Any) ], ... ; # 0..* Supporting information found elsewhere
  ], ...;
  fhir:Condition.note [ Annotation ], ... ; # 0..* Additional information about the Condition
]

Changes since R3

Condition
Condition.clinicalStatus
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/condition-clinical|4.0.0 to http://hl7.org/fhir/ValueSet/condition-clinical|4.6.0
Condition.verificationStatus
  • Change value set from http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.0 to http://hl7.org/fhir/ValueSet/condition-ver-status|4.6.0
Condition.category
  • Remove Binding http://hl7.org/fhir/ValueSet/condition-category (extensible)
Condition.asserter
  • Type Reference: Added Target Type Device

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 12 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors).)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition TUDomainResourceDetailed information about conditions, problems or diagnoses
+ Warning: If category is problems list item, the clinicalStatus should not be unknown
+ Rule: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission.
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!ΣI1..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Condition Clinical Status Codes (Required)
... verificationStatus ?!Σ0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
ConditionVerificationStatus (Required)
... severity 0..1CodeableConceptSubjective severity of condition
Condition/Diagnosis Severity (Preferred)
... code Σ0..1CodeableConceptIdentification of the condition, problem or diagnosis
Condition/Problem/Diagnosis Codes (Example)
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
SNOMED CT Body Structures (Example)
... subject Σ1..1Reference(Patient | Group)Who has the condition?
... encounter Σ0..1Reference(Encounter)The Encounter during which this Condition was created
... onset[x] Σ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate Σ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device)Person or device that asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
+ Rule: Stage SHALL have summary or assessment
.... summary I0..1CodeableConceptSimple summary (disease specific)
Condition Stage (Example)
.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Condition Stage Type (Example)
... evidence I0..*BackboneElementSupporting evidence for the verification status
+ Rule: evidence SHALL have code or details
.... code ΣI0..*CodeableConceptManifestation/symptom
Manifestation and Symptom Codes (Example)
.... detail ΣI0..*Reference(Any)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

UML Diagram (Legend)

Condition (DomainResource)Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The clinical status of the condition (this element modifies the meaning of other elements)clinicalStatus : CodeableConcept [1..1] « null (Strength=Required) ConditionClinicalStatusCodes! »The verification status to support the clinical status of the condition. The verification status pertains to the condition, itself, not to any specific condition attribute (this element modifies the meaning of other elements)verificationStatus : CodeableConcept [0..1] « null (Strength=Required) ConditionVerificationStatus! »A category assigned to the conditioncategory : CodeableConcept [0..*] « null (Strength=Preferred)ConditionCategoryCodes? »A subjective assessment of the severity of the condition as evaluated by the clinicianseverity : CodeableConcept [0..1] « null (Strength=Preferred)Condition/DiagnosisSeverity? »Identification of the condition, problem or diagnosiscode : CodeableConcept [0..1] « null (Strength=Example)Condition/Problem/DiagnosisCo...?? »The anatomical location where this condition manifests itselfbodySite : CodeableConcept [0..*] « Codes describing anatomical locations. May include laterality. (Strength=Example)SNOMEDCTBodyStructures?? »Indicates the patient or group who the condition record is associated withsubject : Reference [1..1] « Patient|Group »The Encounter during which this Condition was created or to which the creation of this record is tightly associatedencounter : Reference [0..1] « Encounter »Estimated or actual date or date-time the condition began, in the opinion of the clinicianonset[x] : DataType [0..1] « dateTime|Age|Period|Range|string »The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Some conditions, such as chronic conditions, are never really resolved, but they can abateabatement[x] : DataType [0..1] « dateTime|Age|Period|Range|string »The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated daterecordedDate : dateTime [0..1]Individual who recorded the record and takes responsibility for its contentrecorder : Reference [0..1] « Practitioner|PractitionerRole|Patient| RelatedPerson »Individual or device that is making the condition statementasserter : Reference [0..1] « Practitioner|PractitionerRole|Patient| RelatedPerson|Device »Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosisnote : Annotation [0..*]StageA simple summary of the stage such as "Stage 3" or "Early Onset". The determination of the stage is disease-specific, such as cancer, retinopathy of prematurity, kidney diseases, Alzheimer's, or Parkinson diseasesummary : CodeableConcept [0..1] « null (Strength=Example)ConditionStage?? »Reference to a formal record of the evidence on which the staging assessment is basedassessment : Reference [0..*] « ClinicalImpression|DiagnosticReport| Observation »The kind of staging, such as pathological or clinical stagingtype : CodeableConcept [0..1] « null (Strength=Example)ConditionStageType?? »EvidenceA manifestation or symptom that led to the recording of this conditioncode : CodeableConcept [0..*] « null (Strength=Example)ManifestationAndSymptomCodes?? »Links to other relevant information, including pathology reportsdetail : Reference [0..*] « Any »A simple summary of the stage such as "Stage 3" or "Early Onset". The determination of the stage is disease-specific, such as cancer, retinopathy of prematurity, kidney diseases, Alzheimer's, or Parkinson diseasestage[0..*]Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the conditionevidence[0..*]

XML Template

<Condition xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this condition --></identifier>
 <clinicalStatus><!-- ?? 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved --></clinicalStatus>
 <verificationStatus><!-- 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error --></verificationStatus>
 <category><!-- ?? 0..* CodeableConcept problem-list-item | encounter-diagnosis --></category>
 <severity><!-- 0..1 CodeableConcept Subjective severity of condition --></severity>
 <code><!-- 0..1 CodeableConcept Identification of the condition, problem or diagnosis --></code>
 <bodySite><!-- 0..* CodeableConcept Anatomical location, if relevant --></bodySite>
 <subject><!-- 1..1 Reference(Group|Patient) Who has the condition? --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this Condition was created --></encounter>
 <onset[x]><!-- 0..1 dateTime|Age|Period|Range|string Estimated or actual date,  date-time, or age --></onset[x]>
 <abatement[x]><!-- ?? 0..1 dateTime|Age|Period|Range|string When in resolution/remission --></abatement[x]>
 <recordedDate value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <recorder><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the condition --></recorder>
 <asserter><!-- 0..1 Reference(Device|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Person or device that asserts this condition --></asserter>
 <stage>  <!-- 0..* Stage/grade, usually assessed formally -->
  <summary><!-- ?? 0..1 CodeableConcept Simple summary (disease specific) --></summary>
  <assessment><!-- ?? 0..* Reference(ClinicalImpression|DiagnosticReport|Observation) Formal record of assessment --></assessment>
  <type><!-- 0..1 CodeableConcept Kind of staging --></type>
 </stage>
 <evidence>  <!-- 0..* Supporting evidence for the verification status -->
  <code><!-- ?? 0..* CodeableConcept Manifestation/symptom --></code>
  <detail><!-- ?? 0..* Reference(Any) Supporting information found elsewhere --></detail>
 </evidence>
 <note><!-- 0..* Annotation Additional information about the Condition --></note>
</Condition>

JSON Template

{doco
  "resourceType" : "Condition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this condition
  "clinicalStatus" : { CodeableConcept }, // C? R!  active | recurrence | relapse | inactive | remission | resolved
  "verificationStatus" : { CodeableConcept }, // unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
  "category" : [{ CodeableConcept }], // C? problem-list-item | encounter-diagnosis
  "severity" : { CodeableConcept }, // Subjective severity of condition
  "code" : { CodeableConcept }, // Identification of the condition, problem or diagnosis
  "bodySite" : [{ CodeableConcept }], // Anatomical location, if relevant
  "subject" : { Reference(Group|Patient) }, // R!  Who has the condition?
  "encounter" : { Reference(Encounter) }, // The Encounter during which this Condition was created
  // onset[x]: Estimated or actual date,  date-time, or age. One of these 5:
  "onsetDateTime" : "<dateTime>",
  "onsetAge" : { Age },
  "onsetPeriod" : { Period },
  "onsetRange" : { Range },
  "onsetString" : "<string>",
  // abatement[x]: When in resolution/remission. One of these 5:
  "abatementDateTime" : "<dateTime>",
  "abatementAge" : { Age },
  "abatementPeriod" : { Period },
  "abatementRange" : { Range },
  "abatementString" : "<string>",
  "recordedDate" : "<dateTime>", // Date record was first recorded
  "recorder" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the condition
  "asserter" : { Reference(Device|Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Person or device that asserts this condition
  "stage" : [{ // Stage/grade, usually assessed formally
    "summary" : { CodeableConcept }, // C? Simple summary (disease specific)
    "assessment" : [{ Reference(ClinicalImpression|DiagnosticReport|Observation) }], // C? Formal record of assessment
    "type" : { CodeableConcept } // Kind of staging
  }],
  "evidence" : [{ // Supporting evidence for the verification status
    "code" : [{ CodeableConcept }], // C? Manifestation/symptom
    "detail" : [{ Reference(Any) }] // C? Supporting information found elsewhere
  }],
  "note" : [{ Annotation }] // Additional information about the Condition
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Condition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Condition.identifier [ Identifier ], ... ; # 0..* External Ids for this condition
  fhir:Condition.clinicalStatus [ CodeableConcept ]; # 1..1 active | recurrence | relapse | inactive | remission | resolved
  fhir:Condition.verificationStatus [ CodeableConcept ]; # 0..1 unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
  fhir:Condition.category [ CodeableConcept ], ... ; # 0..* problem-list-item | encounter-diagnosis
  fhir:Condition.severity [ CodeableConcept ]; # 0..1 Subjective severity of condition
  fhir:Condition.code [ CodeableConcept ]; # 0..1 Identification of the condition, problem or diagnosis
  fhir:Condition.bodySite [ CodeableConcept ], ... ; # 0..* Anatomical location, if relevant
  fhir:Condition.subject [ Reference(Group|Patient) ]; # 1..1 Who has the condition?
  fhir:Condition.encounter [ Reference(Encounter) ]; # 0..1 The Encounter during which this Condition was created
  # Condition.onset[x] : 0..1 Estimated or actual date,  date-time, or age. One of these 5
    fhir:Condition.onsetDateTime [ dateTime ]
    fhir:Condition.onsetAge [ Age ]
    fhir:Condition.onsetPeriod [ Period ]
    fhir:Condition.onsetRange [ Range ]
    fhir:Condition.onsetString [ string ]
  # Condition.abatement[x] : 0..1 When in resolution/remission. One of these 5
    fhir:Condition.abatementDateTime [ dateTime ]
    fhir:Condition.abatementAge [ Age ]
    fhir:Condition.abatementPeriod [ Period ]
    fhir:Condition.abatementRange [ Range ]
    fhir:Condition.abatementString [ string ]
  fhir:Condition.recordedDate [ dateTime ]; # 0..1 Date record was first recorded
  fhir:Condition.recorder [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who recorded the condition
  fhir:Condition.asserter [ Reference(Device|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Person or device that asserts this condition
  fhir:Condition.stage [ # 0..* Stage/grade, usually assessed formally
    fhir:Condition.stage.summary [ CodeableConcept ]; # 0..1 Simple summary (disease specific)
    fhir:Condition.stage.assessment [ Reference(ClinicalImpression|DiagnosticReport|Observation) ], ... ; # 0..* Formal record of assessment
    fhir:Condition.stage.type [ CodeableConcept ]; # 0..1 Kind of staging
  ], ...;
  fhir:Condition.evidence [ # 0..* Supporting evidence for the verification status
    fhir:Condition.evidence.code [ CodeableConcept ], ... ; # 0..* Manifestation/symptom
    fhir:Condition.evidence.detail [ Reference(Any) ], ... ; # 0..* Supporting information found elsewhere
  ], ...;
  fhir:Condition.note [ Annotation ], ... ; # 0..* Additional information about the Condition
]

Changes since Release 3

Condition
Condition.clinicalStatus
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/condition-clinical|4.0.0 to http://hl7.org/fhir/ValueSet/condition-clinical|4.6.0
Condition.verificationStatus
  • Change value set from http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.0 to http://hl7.org/fhir/ValueSet/condition-ver-status|4.6.0
Condition.category
  • Remove Binding http://hl7.org/fhir/ValueSet/condition-category (extensible)
Condition.asserter
  • Type Reference: Added Target Type Device

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 12 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis a

9.2.4.1 Terminology Bindings

PathDefinitionTypeReference
Condition.clinicalStatus RequiredConditionClinicalStatusCodes
Condition.verificationStatus RequiredConditionVerificationStatus
Condition.category PreferredConditionCategoryCodes
Condition.severity PreferredCondition/DiagnosisSeverity
Condition.code ExampleCondition/Problem/DiagnosisCodes
Condition.bodySite Codes describing anatomical locations. May include laterality.ExampleSNOMEDCTBodyStructures
Condition.stage.summary ExampleConditionStage
Condition.stage.type ExampleConditionStageType
Condition.evidence.code ExampleManifestationAndSymptomCodes

9.2.4.2 Constraints

idLevelLocationDescriptionExpression
con-1Rule Condition.stageStage SHALL have summary or assessmentsummary.exists() or assessment.exists()
con-2Rule Condition.evidenceevidence SHALL have code or detailscode.exists() or detail.exists()
con-3Warning (base)If category is problems list item, the clinicalStatus should not be unknowncategory.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-category' and code='problem-list-item').exists() implies clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and code='unknown').exists().not()
con-4Rule (base)If condition is abated, then clinicalStatus must be either inactive, resolved, or remission.abatement.exists() implies (clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='inactive' or code='resolved' or code='remission')).exists())

9.2.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
abatement-agequantityAbatement as age or age rangeCondition.abatement.as(Age) | Condition.abatement.as(Range)
abatement-datedateDate-related abatements (dateTime and period)Condition.abatement.as(dateTime) | Condition.abatement.as(Period)
abatement-stringstringAbatement as a stringCondition.abatement.as(string)
asserterreferencePerson or device that asserts this conditionCondition.asserter
(Practitioner, Device, Patient, PractitionerRole, RelatedPerson)
body-sitetokenAnatomical location, if relevantCondition.bodySite
categorytokenThe category of the conditionCondition.category
clinical-statustokenThe clinical status of the conditionCondition.clinicalStatus
codetokenCode for the conditionCondition.code
encounterreferenceThe Encounter during which this Condition was createdCondition.encounter
(Encounter)
evidencetokenManifestation/symptomCondition.evidence.code
evidence-detailreferenceSupporting information found elsewhereCondition.evidence.detail
(Any)
identifiertokenA unique identifier of the condition recordCondition.identifier
onset-agequantityOnsets as age or age rangeCondition.onset.as(Age) | Condition.onset.as(Range)
onset-datedateDate related onsets (dateTime and Period)Condition.onset.as(dateTime) | Condition.onset.as(Period)
onset-infostringOnsets as a stringCondition.onset.as(string)
patientreferenceWho has the condition?Condition.subject.where(resolve() is Patient)
(Group, Patient)
recorded-date NdateDate record was first recordedCondition.recordedDate
severitytokenThe severity of the conditionCondition.severity
stagetokenSimple summary (disease specific)Condition.stage.summary
subjectreferenceWho has the condition?Condition.subject
(Group, Patient)
verification-statustokenunconfirmed | provisional | differential | confirmed | refuted | entered-in-errorCondition.verificationStatus