MCC eCare Plan Implementation Guide
1.0.0 - STU1 United States of America flag

MCC eCare Plan Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-mcc/ and changes regularly. See the Directory of published versions

Resource Profile: MCC Chronic Condition and Health Concern Profile

Official URL: http://hl7.org/fhir/us/mcc/StructureDefinition/MCCChronCondHealthConcern Version: 1.0.0
Draft as of 2020-06-29 Computable Name: MCCChronCondHealthConcern

This profile constrains US Core Condition Problems and Health Concerns Profile to encourage its use for chronic conditions or health concerns for use in the MCC FHIR Care Plan or other FHIR Care Plans by linkages or references to goals and other resources..

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 conditions or health concerns, 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.evidence (Must Support): supporting evidence for the diagnosis
  • The profile leverages the “Condition-Due To’’ extension (Optional)
  • Staging: This profile adds no constraints 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 pre-coordinated diagnoses terms that include a stage.

Important note with regards to goals: Goals can be associated with a Condition instance use Goal.addresses, or through extensions that convey the appropriate relationship type. For example, the extension:workflow-barrier maybe appropriate to create a link between a Condition instance and a Goal instance.

See the MCC Care Plan SDOH Guidance page for more information when exchanging Social Determinants of Health (SDOH) Problems/Health Concerns. Be sure to consider the appropriate Condition.category to use as well for the SDOH concern. Additionally, codes in MCC Symptom Value Sets are potentially appropriate for Condition.code when Condition.category is Health Concern.

This profile can be bound with any of the value sets found MCC Chronic Condition and Health Concern 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

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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.


... category 1..* CodeableConcept Within the industry, Health Concerns may reside on the problem list along with Problems
... code 1..1 CodeableConcept Please see the MCC Chronic Condition and Health Concern Value Sets Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
.... 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()

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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.


... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept Within the industry, Health Concerns may reside on the problem list along with Problems
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 MCC Chronic Condition and Health Concern Value Sets 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.
con-2: evidence SHALL have code or details
.... 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()

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern
Condition.category:screening-assessmentrequiredUSCoreScreeningAssessmentConditionCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category
Condition.codeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.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-4errorConditionIf 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-5errorConditionCondition.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-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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.


... 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 Within the industry, Health Concerns may reside on the problem list along with Problems
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 MCC Chronic Condition and Health Concern Value Sets 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
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(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.
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) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern
Condition.category:screening-assessmentrequiredUSCoreScreeningAssessmentConditionCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category
Condition.severitypreferredCondition/DiagnosisSeverity
http://hl7.org/fhir/ValueSet/condition-severity
from the FHIR Standard
Condition.codeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.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-4errorConditionIf 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-5errorConditionCondition.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-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Must-Support: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Condition.evidence.detail

Differential View

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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.


... category 1..* CodeableConcept Within the industry, Health Concerns may reside on the problem list along with Problems
... code 1..1 CodeableConcept Please see the MCC Chronic Condition and Health Concern Value Sets Library for value sets that are subsets of US Core Condition Code that can be used at Conditon.code element
.... 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()

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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.


... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept Within the industry, Health Concerns may reside on the problem list along with Problems
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 MCC Chronic Condition and Health Concern Value Sets 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.
con-2: evidence SHALL have code or details
.... 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()

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern
Condition.category:screening-assessmentrequiredUSCoreScreeningAssessmentConditionCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category
Condition.codeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.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-4errorConditionIf 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-5errorConditionCondition.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-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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.


... 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 Within the industry, Health Concerns may reside on the problem list along with Problems
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 MCC Chronic Condition and Health Concern Value Sets 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
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(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.
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) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.category:us-corerequiredUSCoreProblemOrHealthConcern
http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern
Condition.category:screening-assessmentrequiredUSCoreScreeningAssessmentConditionCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category
Condition.severitypreferredCondition/DiagnosisSeverity
http://hl7.org/fhir/ValueSet/condition-severity
from the FHIR Standard
Condition.codeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.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-4errorConditionIf 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-5errorConditionCondition.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-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Must-Support: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Condition.evidence.detail

 

Other representations of profile: CSV, Excel, Schematron