Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2
Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2
Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm, published by HL7 International / Human and Social Services. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/eLTSS/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss | Version: 2.0.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: Condition_eltss | ||
Condition for eLTSS
The following aids in finding the location of eLTSS data elements. See R4 FHIR Mapping page for complete guidance, here we are providing a subset of fields for convenience.
| eLTSS Grouping | eLTSS Data Element Name | Data Element Definition (includes examples, expected list of values and usage note where applicable) | FHIR R4 Resource Element(s) | FHIR R4 Resource Element Cardinality (with US Core Constraints) | Additional Mapping Details | Important change |
|---|---|---|---|---|---|---|
| Person Centered Planning | Assessed Need | The clinical and/or community-based necessity or desire as identified through an assessment that should be addressed by a service. | CarePlan → addresses(Condition) Condition → code → text Condition → category |
CarePlan ...addresses(Condition) 0..* ......code 1 .........text 0..1 ......category 1..* |
1) Will use CarePlan → addresses to reference the Condition(s) for the care plan being developed. 2) code is required by US Core and is a CodeableConcept which per US Core is bound to the extensible Problem Value Set. That value set is based on SNOMED-CT and includes very specific values that do not line up with assessed needs. Per US Core's documentation on extensible CodeableConcepts, the CodeableConcept's text element can be used "if no suitable codes exist", so we can use the text element for the assessed need. Additionally, the Gravity SDOH FHIR IG has a value set of SDOH conditions. 3) Each assessed need should go into a separate Condition element so each can potentially be linked to a service(s) that addresses it. 4) Category is required by US Core and is a CodeableConcept which per US Core is bound to the extensible US Core Condition Category Codes value set (http://hl7.org/fhir/ValueSet/condition-category) which has values: problem-list-item, encounter-diagnosis and health-concern. The additional 'assessed-need' code can be used to relate that the Condition instance is about the clinical and/or community-based necessity or desire, as identified through an assessment, that should be addressed by a service. Consider also using the US Core 6.1.0 screening-assessment categories https://www.hl7.org/fhir/us/core/ValueSet-us-core-screening-assessment-condition-category.html. 5) An "assessed need" condition can refer to another condition via the condition-dueTo extension. |
Now using US CORE Condition Category value set element "Health Concern" |
| Data Requirements Not Specific to eLTSS Dataset Data Elements This section documents data elements that are mandatory per FHIR XML schemas or US Core requirements, but that do not align with individual eLTSS Dataset data elements. |
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|---|---|---|---|---|
| FHIR Data Element Name Requirement Source |
Data Element Definition | FHIR R4 Resource Element(s) | FHIR R4 Resource Element Cardinality (with US Core Constraints) | Additional Mapping Details |
| Condition Verification Status US Core |
The verification status to support the clinical status of the condition. | Condition → verificationStatus | Condition ...verificationStatus 1 |
1) verificationStatus is required by US Core, and must use the ConditionVerificationStatus value set. Possible values are: provisional, differential, confirmed, refuted, entered-in-error, and unknown. |
| Condition Clinical Status US Core |
The clinical status of the condition. | Condition → clinicalStatus | Condition ...clinicalStatus 1 |
1) clinicalStatus is required by US Core if the value of verificationStatus is not "entered-in-error". FHIR requires that the values come from the Condition Clinical Status Codes value set, which has values: active, recurrence, inactive, remission, and resolved. |
| Condition Subject US Core |
Who has the condition. | Condition → subject(Patient) | Condition ...subject 1 |
1) subject is required by US Core, and is a reference to a Patient. |
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreConditionProblemsHealthConcernsProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Condition |
0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses | |
  dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |
 category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Required Pattern: At least the following |
   coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
 system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |
 code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |
 code |
1..1 | CodeableConcept | Assessed Need Code | |
 coding |
S | 0..* | Coding | Code defined by a terminology system |
| system |
S | 0..1 | uri | Identity of the terminology system |
| code |
S | 0..1 | code | Symbol in syntax defined by the system |
 subject |
1..1 | Reference(Patient_eltss) | (USCDI) Who has the condition? | |
| recorder |
0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition | |
| asserter |
0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition | |
| stage |
||||
| assessment |
0..* | Reference(Observation_eltss | ClinicalImpression | DiagnosticReport) | Formal record of assessment | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition |
C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error |
 implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| assertedDate |
S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
| dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |
 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 |
 category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |
| code |
SΣ | 1..1 | CodeableConcept | Assessed Need Code Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient |
| coding |
SΣ | 0..* | Coding | Code defined by a terminology system |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| subject |
SΣ | 1..1 | Reference(Patient_eltss) | (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 |
| recorder |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition |
| asserter |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinicalfrom the FHIR Standard | |
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-statusfrom the FHIR Standard | |
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.category:us-core | required | USCoreProblemOrHealthConcernhttp://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern | |
| Condition.category:screening-assessment | required | USCoreScreeningAssessmentConditionCategoryhttp://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category | |
| Condition.category:assessed-need | extensible | Pattern: assessed-needhttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.code | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code |
| Id | Grade | Path(s) | Details | Requirements |
| 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 con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | ||||
| 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.
| |||||
| 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 | ||||
| dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |||||
| 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 | ||||
| category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following | ||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
 coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
 text |
0..1 | string | Plain text representation of the concept | |||||
| 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 | Assessed Need Code Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
SΣ | 0..* | Coding | Code defined by a terminology system | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| bodySite |
Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | ||||
| subject |
SΣ | 1..1 | Reference(Patient_eltss) | (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_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition | ||||
| asserter |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition | ||||
| stage |
C | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment | ||||
| 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(Observation_eltss | ClinicalImpression | DiagnosticReport) | 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 con-2: evidence SHALL have code or details | ||||
| 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) | Supporting information found elsewhere | ||||
| note |
0..* | Annotation | Additional information about the Condition | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Condition.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinicalfrom the FHIR Standard | ||||
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-statusfrom the FHIR Standard | ||||
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.category:us-core | required | USCoreProblemOrHealthConcernhttp://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern | ||||
| Condition.category:screening-assessment | required | USCoreScreeningAssessmentConditionCategoryhttp://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category | ||||
| Condition.category:assessed-need | extensible | Pattern: assessed-needhttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.severity | preferred | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | ||||
| Condition.code | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code | ||||
| Condition.bodySite | example | SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-sitefrom the FHIR Standard | ||||
| Condition.stage.summary | example | ConditionStagehttp://hl7.org/fhir/ValueSet/condition-stagefrom the FHIR Standard | ||||
| Condition.stage.type | example | ConditionStageTypehttp://hl7.org/fhir/ValueSet/condition-stage-typefrom the FHIR Standard | ||||
| Condition.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptomfrom the FHIR Standard |
| 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() | |
| 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
Must-Support: 4 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Differential View
This structure is derived from USCoreConditionProblemsHealthConcernsProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition |
0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses | |
| dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |
| category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |
| code |
1..1 | CodeableConcept | Assessed Need Code | |
| coding |
S | 0..* | Coding | Code defined by a terminology system |
| system |
S | 0..1 | uri | Identity of the terminology system |
| code |
S | 0..1 | code | Symbol in syntax defined by the system |
| subject |
1..1 | Reference(Patient_eltss) | (USCDI) Who has the condition? | |
| recorder |
0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition | |
| asserter |
0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition | |
| stage |
||||
| assessment |
0..* | Reference(Observation_eltss | ClinicalImpression | DiagnosticReport) | Formal record of assessment | |
| Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition |
C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| assertedDate |
S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate |
| dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |
| 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 |
| category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |
| code |
SΣ | 1..1 | CodeableConcept | Assessed Need Code Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient |
| coding |
SΣ | 0..* | Coding | Code defined by a terminology system |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| subject |
SΣ | 1..1 | Reference(Patient_eltss) | (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 |
| recorder |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition |
| asserter |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinicalfrom the FHIR Standard | |
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-statusfrom the FHIR Standard | |
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.category:us-core | required | USCoreProblemOrHealthConcernhttp://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern | |
| Condition.category:screening-assessment | required | USCoreScreeningAssessmentConditionCategoryhttp://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category | |
| Condition.category:assessed-need | extensible | Pattern: assessed-needhttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.code | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code |
| Id | Grade | Path(s) | Details | Requirements |
| 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 con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | ||||
| 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.
| |||||
| 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 | ||||
| dueTo |
0..* | Reference(Condition_eltss) | Causes for this Condition URL: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-dueTo | |||||
| 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 | ||||
| category:assessed-need |
S | 0..1 | CodeableConcept | Assessed Need Category Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: assessed-need | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| 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 | Assessed Need Code Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
SΣ | 0..* | Coding | Code defined by a terminology system | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| bodySite |
Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | ||||
| subject |
SΣ | 1..1 | Reference(Patient_eltss) | (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_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Who recorded the condition | ||||
| asserter |
Σ | 0..1 | Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | Patient_eltss | eLTSS RelatedPerson Profile) | Person who asserts this condition | ||||
| stage |
C | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment | ||||
| 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(Observation_eltss | ClinicalImpression | DiagnosticReport) | 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 con-2: evidence SHALL have code or details | ||||
| 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) | Supporting information found elsewhere | ||||
| note |
0..* | Annotation | Additional information about the Condition | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Condition.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinicalfrom the FHIR Standard | ||||
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-statusfrom the FHIR Standard | ||||
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.category:us-core | required | USCoreProblemOrHealthConcernhttp://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern | ||||
| Condition.category:screening-assessment | required | USCoreScreeningAssessmentConditionCategoryhttp://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category | ||||
| Condition.category:assessed-need | extensible | Pattern: assessed-needhttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.severity | preferred | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | ||||
| Condition.code | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code | ||||
| Condition.bodySite | example | SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-sitefrom the FHIR Standard | ||||
| Condition.stage.summary | example | ConditionStagehttp://hl7.org/fhir/ValueSet/condition-stagefrom the FHIR Standard | ||||
| Condition.stage.type | example | ConditionStageTypehttp://hl7.org/fhir/ValueSet/condition-stage-typefrom the FHIR Standard | ||||
| Condition.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptomfrom the FHIR Standard |
| 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() | |
| 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
Must-Support: 4 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron
IG © 2020+ HL7 International / Human and Social Services. Package hl7.fhir.us.eltss#2.0.0 based on FHIR 4.0.1. Generated 2024-04-26
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