International Patient Access
1.1.0 - STU1 International flag

International Patient Access, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ipa/ and changes regularly. See the Directory of published versions

Resource Profile: IPA-Condition

Official URL: http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-condition Version: 1.1.0
Standards status: Trial-use Computable Name: IPACondition

Copyright/Legal: Used by permission of HL7 International all rights reserved Creative Commons License

Minimum expectations for a Condition resource when accessed via an International Patient Access API. This profile communicates information about a patient's condition or diagnosis, such as recording primary and secondary diagnoses for encounters or justification for past medications. For the use of the condition resource to get a list of the patient's current problem list, use the IPA-Problem-List-Item profile instead. The difference between this profile and the IPA Problem List Item profile is that this profile does not specify or require a category.

Mandatory and Must Support Data Elements

The following data elements must always be present (in other words, mandatory resource properties where the minimum cardinality is 1) or must be supported (Must Support definition). Servers cannot restrict access to mandatory elements when authorizing an application. However, servers may choose to provide additional information or may be required to do so by national or other profiles that apply to the server's context.

Each Condition SHALL have:

  • a code identifying the condition, problem, or diagnosis
  • a patient

Applications must also support:

  • a clinical status
  • a verification status
  • one or more category codes used to group conditions

Profile Specific Implementation Rules and Guidance

Accessing Condition Resources

Clients can access a Condition resources using:

GET [url]/Condition/[id]

where id is found in some other resource that refers to a Condition. The result of this read is a Condition resource, or an error if there is no resource the client can access for that id. Alternatively, the client may search for condition resources.

Condition Codes

All Condition resources are required to have a code, but the coding systems used around the world and even within jurisdictions very wildly. This specification does not fix any kind of value set that controls what kind of codes can be used - other national specifications etc will place their own restrictions on the codes.

Client Applications should be prepared to encounter codes they do not recognize and handle the records accordingly. Servers SHOULD populate Condition.code.coding.display and/or Condition.code.text so that clients can always at least display the condition even if they do not know the codes that are used.

Clients should be careful making use of the code search parameter given that the codes used vary so much.

Safety Issues

  • Clients SHALL not treat all conditions as if they are part of the patient's current problem list
    • Note that some Condition resources may not have these status codes - this is usually due to poor record keeping reflected in legacy data
    • Servers SHOULD avoid leaving these status codes missing
  • Clients SHALL pay attention to the clinicalStatus and verificationStatus and display and process them correctly
  • Clients SHALL still work safely when the server does not support all the search parameters listed in the IPA Server Capability Statement. (see also Search advice)

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* Condition 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
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: 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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... clinicalStatus ?!SOΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
ObligationsActor
SHALL:populate-if-known Server
SHALL:handle Client
... category SO 0..* CodeableConcept problem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


ele-1: All FHIR elements must have a @value or children
ObligationsActor
SHALL:populate-if-known Server
... code SOΣ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
ObligationsActor
SHALL:populate-if-known Server
SHOULD:handle Client
... subject SOΣ 1..1 Reference(IPA-Patient) Who has the condition?
ele-1: All FHIR elements must have a @value or children
ObligationsActor
SHALL:populate-if-known Server

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.codeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard

 

Other representations of profile: CSV, Excel, Schematron