Australian Digital Health Agency FHIR
1.2.0-ci-build - draft
Australian Digital Health Agency FHIR
1.2.0-ci-build - draft
Australian Digital Health Agency FHIR, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/mcv/ and changes regularly. See the Directory of published versions
| Official URL: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-condition-mcv-1 | Version: | |||
| Active as of 2024-09-16 | Computable Name: MHRConditionMCV | |||
Copyright/Legal: Copyright © 2024 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/. |
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The purpose of this profile is to support a consolidated view of medical conditions and past medical history contained in a patient's My Health Record. This profile is derived from the AU Core Condition profile and describes the data structures and obligations to be met when conforming to this profile.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from AUCoreCondition
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
  Condition |
AUCoreCondition | |||||||
  id |
1..1 | id | Logical id of this artifact | |||||
| clinicalStatus |
O | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
| ||||
| category |
O | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis
| ||||
| code |
O | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis
| ||||
 subject |
O | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||
 onset[x] |
O | 0..1 | dateTime | Estimated or actual date or date-time
| ||||
| abatement[x] |
O | 0..1 | dateTime | When in resolution/remission
| ||||
| recordedDate |
SO | 1..1 | dateTime | Date record was first recorded
| ||||
 note |
O | 0..1 | Annotation | Additional information about the Condition
| ||||
| Documentation for this format | ||||||||
| Name | Flags | Card. | Type | Description & Constraints | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition |
C | 0..* | AUCoreCondition | A condition, problem or diagnosis statement in an Australian healthcare context 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 | 1..1 | id | Logical id of this artifact | ||||||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||||
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||||||
 clinicalStatus |
?!SOΣC | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
| ||||||||
| verificationStatus |
?!SOΣC | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
| ||||||||
| category |
SO | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
| ||||||||
| severity |
SO | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (extensible)
| ||||||||
| code |
SOΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Clinical Condition  (extensible)
| ||||||||
| subject |
SOΣ | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||||||
| onset[x] |
SOΣ | 0..1 | dateTime | Estimated or actual date or date-time
| ||||||||
| abatement[x] |
SOC | 0..1 | dateTime | When in resolution/remission
| ||||||||
| recordedDate |
SOΣ | 1..1 | dateTime | Date record was first recorded
| ||||||||
| note |
SO | 0..1 | Annotation | Additional information about the Condition
| ||||||||
| Documentation for this format | ||||||||||||
| Path | Conformance | ValueSet | URI |
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1from the FHIR Standard | |
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1from the FHIR Standard | |
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.severity | extensible | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | |
| Condition.code | extensible | ClinicalCondition https://healthterminologies.gov.au/fhir/ValueSet/clinical-condition-1 |
| Name | Flags | Card. | Type | Description & Constraints | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition |
C | 0..* | AUCoreCondition | A condition, problem or diagnosis statement in an Australian healthcare context 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 | 1..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 | |||||||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||||||
| identifier |
Σ | 0..* | Identifier | External Ids for this condition | ||||||||
| clinicalStatus |
?!SOΣC | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
| ||||||||
| verificationStatus |
?!SOΣC | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
| ||||||||
| category |
SO | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
| ||||||||
| severity |
SO | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (extensible)
| ||||||||
| code |
SOΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Clinical Condition (extensible)
| ||||||||
| bodySite |
ΣC | 0..* | CodeableConcept | Anatomical location, if relevant Binding: Body Site (extensible)au-core-cond-02: If a coded body site is provided, at least one code shall be from SNOMED CT | ||||||||
| subject |
SOΣ | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||||||
| onset[x] |
SOΣ | 0..1 | dateTime | Estimated or actual date or date-time
| ||||||||
| abatement[x] |
SOC | 0..1 | dateTime | When in resolution/remission
| ||||||||
| recordedDate |
SOΣ | 1..1 | dateTime | 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 |
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: Clinical Finding (preferred) | ||||||||
| detail |
ΣC | 0..* | Reference(Resource) | Supporting information found elsewhere | ||||||||
| note |
SO | 0..1 | Annotation | Additional information about the Condition
| ||||||||
| Documentation for this format | ||||||||||||
| Path | Conformance | ValueSet | URI | |||
| Condition.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1from the FHIR Standard | ||||
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1from the FHIR Standard | ||||
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.severity | extensible | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | ||||
| Condition.code | extensible | ClinicalCondition https://healthterminologies.gov.au/fhir/ValueSet/clinical-condition-1 | ||||
| Condition.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | ||||
| 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 | preferred | ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 |
This structure is derived from AUCoreCondition
Differential View
This structure is derived from AUCoreCondition
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Condition |
AUCoreCondition | |||||||
| id |
1..1 | id | Logical id of this artifact | |||||
| clinicalStatus |
O | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
| ||||
| category |
O | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis
| ||||
| code |
O | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis
| ||||
| subject |
O | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||
| onset[x] |
O | 0..1 | dateTime | Estimated or actual date or date-time
| ||||
| abatement[x] |
O | 0..1 | dateTime | When in resolution/remission
| ||||
| recordedDate |
SO | 1..1 | dateTime | Date record was first recorded
| ||||
| note |
O | 0..1 | Annotation | Additional information about the Condition
| ||||
| Documentation for this format | ||||||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition |
C | 0..* | AUCoreCondition | A condition, problem or diagnosis statement in an Australian healthcare context 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 | 1..1 | id | Logical id of this artifact | ||||||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||||||
| clinicalStatus |
?!SOΣC | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
| ||||||||
| verificationStatus |
?!SOΣC | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
| ||||||||
| category |
SO | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
| ||||||||
| severity |
SO | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (extensible)
| ||||||||
| code |
SOΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Clinical Condition (extensible)
| ||||||||
| subject |
SOΣ | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||||||
| onset[x] |
SOΣ | 0..1 | dateTime | Estimated or actual date or date-time
| ||||||||
| abatement[x] |
SOC | 0..1 | dateTime | When in resolution/remission
| ||||||||
| recordedDate |
SOΣ | 1..1 | dateTime | Date record was first recorded
| ||||||||
| note |
SO | 0..1 | Annotation | Additional information about the Condition
| ||||||||
| Documentation for this format | ||||||||||||
| Path | Conformance | ValueSet | URI |
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1from the FHIR Standard | |
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1from the FHIR Standard | |
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | |
| Condition.severity | extensible | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | |
| Condition.code | extensible | ClinicalCondition https://healthterminologies.gov.au/fhir/ValueSet/clinical-condition-1 |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition |
C | 0..* | AUCoreCondition | A condition, problem or diagnosis statement in an Australian healthcare context 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 | 1..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 | |||||||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||||||
| identifier |
Σ | 0..* | Identifier | External Ids for this condition | ||||||||
| clinicalStatus |
?!SOΣC | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
| ||||||||
| verificationStatus |
?!SOΣC | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
| ||||||||
| category |
SO | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
| ||||||||
| severity |
SO | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (extensible)
| ||||||||
| code |
SOΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Clinical Condition (extensible)
| ||||||||
| bodySite |
ΣC | 0..* | CodeableConcept | Anatomical location, if relevant Binding: Body Site (extensible)au-core-cond-02: If a coded body site is provided, at least one code shall be from SNOMED CT | ||||||||
| subject |
SOΣ | 1..1 | Reference(MHR Patient) | Who has the condition?
| ||||||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||||||
| onset[x] |
SOΣ | 0..1 | dateTime | Estimated or actual date or date-time
| ||||||||
| abatement[x] |
SOC | 0..1 | dateTime | When in resolution/remission
| ||||||||
| recordedDate |
SOΣ | 1..1 | dateTime | 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 |
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: Clinical Finding (preferred) | ||||||||
| detail |
ΣC | 0..* | Reference(Resource) | Supporting information found elsewhere | ||||||||
| note |
SO | 0..1 | Annotation | Additional information about the Condition
| ||||||||
| Documentation for this format | ||||||||||||
| Path | Conformance | ValueSet | URI | |||
| Condition.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Condition.clinicalStatus | required | ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1from the FHIR Standard | ||||
| Condition.verificationStatus | required | ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1from the FHIR Standard | ||||
| Condition.category | extensible | ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-categoryfrom the FHIR Standard | ||||
| Condition.severity | extensible | Condition/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severityfrom the FHIR Standard | ||||
| Condition.code | extensible | ClinicalCondition https://healthterminologies.gov.au/fhir/ValueSet/clinical-condition-1 | ||||
| Condition.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | ||||
| 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 | preferred | ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 |
This structure is derived from AUCoreCondition
Other representations of profile: CSV, Excel, Schematron
IG © 2023+ Australian Digital Health Agency. Package au.digitalhealth.r4#1.2.0-ci-build based on FHIR 4.0.1. Generated 2024-09-16
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