International Patient Summary Implementation Guide
2.0.0 -

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions

## Resource Profile: Condition (IPS)

Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/Condition-uv-ips | Version: 2.0.0
Standards status: Trial-use Active as of 2024-06-19 | Maturity Level: 3 | Computable Name: ConditionUvIps

This profile represents the constraints applied to the Condition resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of a problem is represented in the patient summary as an instance of the Condition resource constrained by this profile.

Usages:

- Use this Profile: Bundle (IPS)
- Refer to this Profile: Composition (IPS)
- Examples for this Profile: Condition/eumfh-39-07-1
- CapabilityStatements using this Profile: IPS Server Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Documentation of a health problem of the patient Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus | ?!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 | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO Σ | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for onset[x] | SO Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | SO Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
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 | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | Condition | Documentation of a health problem of the patient
clinicalStatus | SO | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus |  | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
category | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite |  | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for onset[x] | SO | 0..1 | dateTime, Age, Period, Range, string | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onset[x]:onsetDateTime | SO | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.category | Base | extensible | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Documentation of a health problem of the patient Constraints: con-3, con-4, con-5
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | ?!SO Σ C | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus | ?!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 | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO Σ | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
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
display | Σ | 0..1 | string | Text alternative for the resource
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
Slices for onset[x] | SO Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | SO Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
abatement[x] | C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | 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

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
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 | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Condition.subject.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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
Documentation for this format

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.onset[x]

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Documentation of a health problem of the patient Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus | ?!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 | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO Σ | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for onset[x] | SO Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | SO Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
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 | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | Condition | Documentation of a health problem of the patient
clinicalStatus | SO | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus |  | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
category | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite |  | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for onset[x] | SO | 0..1 | dateTime, Age, Period, Range, string | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onset[x]:onsetDateTime | SO | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.category | Base | extensible | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Documentation of a health problem of the patient Constraints: con-3, con-4, con-5
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | ?!SO Σ C | 0..1 | CodeableConceptIPS | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
verificationStatus | ?!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 | SO | 0..* | CodeableConceptIPS | problem-list-item | encounter-diagnosis Binding: Problem Type - IPS (extensible)
Additional Bindings | Purpose
Problem Type (LOINC) | candidate
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
severity | SO | 0..1 | CodeableConceptIPS | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
code | SO Σ | 1..1 | CodeableConceptIPS | Identification of the condition, problem or diagnosis Binding: Problems - IPS (preferred): Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (preferred)
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who has the condition?
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
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
display | Σ | 0..1 | string | Text alternative for the resource
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
Slices for onset[x] | SO Σ | 0..1 |  | Estimated or actual date, date-time, or age Slice: Unordered, Open by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
onset[x]:onsetDateTime | SO Σ | 0..1 | dateTime | Estimated or actual date, date-time, or age
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
abatement[x] | C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | 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

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
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 | Problem Type - IPS | 📦2.0.0 | This IG
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📦4.0.1 | FHIR Std.
Condition.code | Base | preferred | Problems - IPS | 📦2.0.0 | This IG
Condition.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Condition.subject.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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Condition |  |
clinicalStatus | SHALL:populate-if-known | SHALL:handle SHOULD:display
category | SHALL:populate-if-known | SHALL:handle SHOULD:display
severity | SHALL:populate-if-known | SHALL:handle SHOULD:display
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
Slices for onset[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
onset[x]:onsetDateTime | SHOULD:able-to-populate | SHALL:handle SHOULD:display
Documentation for this format

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.onset[x]

Maturity: 3

Other representations of profile: CSV, Excel, Schematron