QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.0)

QI-Core Implementation Guide, Clinical Quality Improvement WG - CI build for vesion 4.0.0). This version is based on the current content of https://github.com/cqframework/qi-core/ and changes regularly. See the Directory of published versions

7.7.0 Condition/Diagnosis/Problem

QDM defines Condition/Diagnosis/Problem as a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but they may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy).

QDM Context QI-Core R4 Comments
Diagnosis Condition
Condition.clinicalStatus defines active/inactive
Condition.verificationStatus confirmed, unconfirmed provisional, differential, refuted, entered-in-error,
Condition.category problem-list-item, encounter-diagnosis, health-concern
QDM Attributes
code Condition.code
id Condition.id
Prevalence Period Condition.onset[x] May be dateTime, Age, Period Range, string
Condition.abatement[x] May be dateTime, Age, Period Range, string
Author dateTime Condition.recordedDate
Severity Condition.severity severe, moderate, mild
Anatomical Location Site Condition.bodySite
Recorder Condition.recorder Individual who recorded the record and takes responsibility for its content
Condition.asserter Individual who is making the condition statement