De-Identified, Anonymized FHIR Profiles Library
0.1.0 - STU1 Release 1 - Standard for Trial-Use

De-Identified, Anonymized FHIR Profiles Library, published by HL7 International / Cross Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-dapl/ and changes regularly. See the Directory of published versions

## Resource Profile: De-Identified UDS Plus Diagnosis

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-diagnosis | Version: 0.1.0
Standards status: Trial-use | Maturity Level: 1 | Computable Name: UDSPlusDiagnosis

The UDS+ profile is based on the Condition resource and establishes the core elements, extensions, vocabularies and value sets for representing Diagnosis for UDS+ program.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

### Introduction

This profile is used to represent de-identified diagnosis information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes diagnosis dates, visit dates, onset dates etc.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Condition resource text element may contain information such as the visit date, onset date. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original Condition resource id should not be included in the De-identified condition instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Condition. All resource references to the Condition submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

- subject
- encounter

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

- onsetDate
- abatementDate
- recordedDate

Examples

Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

Usages:

- Refer to this Profile: De-Identified UDS Plus Encounter
- Examples for this Profile: Condition/de-identified-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | De-Identified UDS Plus Diagnosis Constraints: con-3, con-4, con-5
id | S Σ | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 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 | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
code | S Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
Slices for onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | S Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Slices for abatement[x] | C | 0..1 |  | When in resolution/remission Slice: Unordered, Open by type:$this
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
abatement[x]:abatementDateTime | S C | 0..1 | dateTime | When in resolution/remission
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 Condition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | Condition | De-Identified UDS Plus Diagnosis
id | S | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
text |  | 0..0 |  | Plain text representation of the concept
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
text |  | 0..0 |  | Plain text representation of the concept
category | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis
text |  | 0..0 |  | Plain text representation of the concept
code | S | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
text |  | 0..0 |  | Plain text representation of the concept
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
display |  | 0..0 |  | Text alternative for the resource
encounter | S | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
display |  | 0..0 |  | Text alternative for the resource
onsetDateTime | S | 0..1 | dateTime | Estimated or actual date, date-time, or age
abatementDateTime | S | 0..1 | dateTime | When in resolution/remission
recordedDate | S | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | De-Identified UDS Plus Diagnosis Constraints: con-3, con-4, con-5
id | S Σ | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
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 | Σ | 0..* | Coding | Code defined by a terminology system
verificationStatus | ?!S Σ C | 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.
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 | Σ | 0..* | Coding | Code defined by a terminology system
category | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
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 | Σ | 0..* | Coding | Code defined by a terminology system
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 | S Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
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 | Σ | 0..* | Coding | Code defined by a terminology system
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
Slices for onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | S Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Slices for abatement[x] | C | 0..1 |  | When in resolution/remission Slice: Unordered, Open by type:$this
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
abatement[x]:abatementDateTime | S C | 0..1 | dateTime | When in resolution/remission
recordedDate | S Σ | 0..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 Constraints: con-1
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 Constraints: con-2
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Condition.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Condition.encounter.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Condition.stage.summary | Base | example | Condition Stage | 📍4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📍4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 Condition

Summary

Mandatory: 3 elements
Must-Support: 11 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- De-Identified UDS Plus Encounter (http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-encounter)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | De-Identified UDS Plus Diagnosis Constraints: con-3, con-4, con-5
id | S Σ | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 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 | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
code | S Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
Slices for onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | S Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Slices for abatement[x] | C | 0..1 |  | When in resolution/remission Slice: Unordered, Open by type:$this
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
abatement[x]:abatementDateTime | S C | 0..1 | dateTime | When in resolution/remission
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Differential View

This structure is derived from Condition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | Condition | De-Identified UDS Plus Diagnosis
id | S | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
text |  | 0..0 |  | Plain text representation of the concept
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
text |  | 0..0 |  | Plain text representation of the concept
category | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis
text |  | 0..0 |  | Plain text representation of the concept
code | S | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
text |  | 0..0 |  | Plain text representation of the concept
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
display |  | 0..0 |  | Text alternative for the resource
encounter | S | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
display |  | 0..0 |  | Text alternative for the resource
onsetDateTime | S | 0..1 | dateTime | Estimated or actual date, date-time, or age
abatementDateTime | S | 0..1 | dateTime | When in resolution/remission
recordedDate | S | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | De-Identified UDS Plus Diagnosis Constraints: con-3, con-4, con-5
id | S Σ | 0..1 | id | The de-identified Condition identifier created by the health center to send data to UDS+ Data Receiver
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate | S | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
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 | Σ | 0..* | Coding | Code defined by a terminology system
verificationStatus | ?!S Σ C | 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.
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 | Σ | 0..* | Coding | Code defined by a terminology system
category | S | 1..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
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 | Σ | 0..* | Coding | Code defined by a terminology system
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 | S Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: US Core Condition Codes (extensible): The set of codes indicating the diagnosis
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 | Σ | 0..* | Coding | Code defined by a terminology system
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who has the condition?
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
encounter | S Σ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter created as part of
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
Slices for onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | S Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Slices for abatement[x] | C | 0..1 |  | When in resolution/remission Slice: Unordered, Open by type:$this
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
abatement[x]:abatementDateTime | S C | 0..1 | dateTime | When in resolution/remission
recordedDate | S Σ | 0..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 Constraints: con-1
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 Constraints: con-2
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📦8.0.1 | US Core v8.0
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Condition.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Condition.encounter.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Condition.stage.summary | Base | example | Condition Stage | 📍4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📍4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 Condition

Summary

Mandatory: 3 elements
Must-Support: 11 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- De-Identified UDS Plus Encounter (http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-encounter)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate

Maturity: 1

Other representations of profile: CSV, Excel, Schematron