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

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

Important note with regards to Condition.extension:resource-pertainsToGoal: The relationship between goal and the thing that it addresses is different from the relationship between goal and reason the goal exists. The ability to define these relationship are contextual and should be the responsibility of the data source to determine. These differentiations should be handled by business rules. In order to avoid being prescriptive we have chosen not to use an invariant. However, it is possible to create what can be seen as a circular reference where a Goal instance that is the target of the resource-pertainsToGoal also references the Condition. To explain further, the difference is in the context of use. Which is why we currently do not resitrict the resource-pertainsToGoal to only those Goals that do not reference the Condition, nor block our Goal profile from referenceing Condition instances that refer to the Goal through resource-pertainsToGoal.

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

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

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

Profile Relationship Diagram example: Chronic Kidney Disease

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

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
code		1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
onset[x]	S	0..1	dateTime S, Age, Period, Range, string	(USCDI) Estimated or actual date, date-time, or age
recordedDate	S	0..1	dateTime	(USCDI) Date record was first recorded
evidence	S	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
detail		0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
assertedDate	S	0..1	dateTime	(USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) 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) 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
code	SΣ	1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who has the condition?
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime
recordedDate	SΣ	0..1	dateTime	(USCDI) Date record was first recorded
evidence	SC	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.category:us-core	required	USCoreProblemOrHealthConcern
Condition.category:screening-assessment	required	USCoreScreeningAssessmentConditionCategory
Condition.code	extensible	USCoreConditionCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
assertedDate	S	0..1	dateTime	(USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) 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) 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	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	(USCDI) 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
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	SC	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
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	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.category:us-core	required	USCoreProblemOrHealthConcern
Condition.category:screening-assessment	required	USCoreScreeningAssessmentConditionCategory
Condition.severity	preferred	Condition/DiagnosisSeverity
Condition.code	extensible	USCoreConditionCodes
Condition.bodySite	example	SNOMEDCTBodyStructures
Condition.stage.summary	example	ConditionStage
Condition.stage.type	example	ConditionStageType
Condition.evidence.code	example	ManifestationAndSymptomCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
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
Condition		0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
code		1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
onset[x]	S	0..1	dateTime S, Age, Period, Range, string	(USCDI) Estimated or actual date, date-time, or age
recordedDate	S	0..1	dateTime	(USCDI) Date record was first recorded
evidence	S	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
detail		0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
assertedDate	S	0..1	dateTime	(USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) 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) 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
code	SΣ	1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who has the condition?
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime
recordedDate	SΣ	0..1	dateTime	(USCDI) Date record was first recorded
evidence	SC	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.category:us-core	required	USCoreProblemOrHealthConcern
Condition.category:screening-assessment	required	USCoreScreeningAssessmentConditionCategory
Condition.code	extensible	USCoreConditionCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
assertedDate	S	0..1	dateTime	(USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
Condition-dueTo		0..*	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Causes for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) 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) 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	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Please see the Condition Value Set Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	(USCDI) 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
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	SC	0..*	BackboneElement	Supporting evidence for the presence of a chronic condition should be provided whenever possible.
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	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Condition.evidence allows asserting an encoded term code OR pointing to a profile where more detail is available. The use of referring to detail through referred profiles is encouraged. Slice: Unordered, Open by profile:resolve()
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.category:us-core	required	USCoreProblemOrHealthConcern
Condition.category:screening-assessment	required	USCoreScreeningAssessmentConditionCategory
Condition.severity	preferred	Condition/DiagnosisSeverity
Condition.code	extensible	USCoreConditionCodes
Condition.bodySite	example	SNOMEDCTBodyStructures
Condition.stage.summary	example	ConditionStage
Condition.stage.type	example	ConditionStageType
Condition.evidence.code	example	ManifestationAndSymptomCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
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

Must-Support: 4 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-dueTo
• http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal

Slices

This structure defines the following Slices:

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