US Quality Core Implementation Guide
1.0.0-ballot - STU 1 - ballot United States of America flag

US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core Condition Problems Health Concerns

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreConditionProblemsHealthConcerns
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.9

Profile of Condition for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

Profile element Description USCDI+ Quality Data Element(s)
abatement[x] When in resolution/remission Problems: Date of Resolution
category:us-core problem-list-item | health-concern Health Status Assessments: Health Concerns
clinicalStatus active | recurrence | relapse | inactive | remission | resolved Problems: Condition Status
code Identification of the condition, problem or diagnosis Health Status Assessments: Alcohol Use, Health Status Assessments: Disability Status, Health Status Assessments: Functional Status, Health Status Assessments: Health Concerns, Health Status Assessments: Mental/Cognitive Status, Health Status Assessments: Physical Activity, Health Status Assessments: SDOH Assessment, Health Status Assessments: Substance Use, Problems: Problems, Problems: SDOH Problems/Health Concerns
extension:assertedDate Date the condition was first asserted Problems: Date of Diagnosis
onset[x] Estimated or actual date, date-time, or age Problems: Date of Onset
recordedDate Date record was first recorded Problems: Date of Diagnosis
recorder Who recorded the condition Provenance: Author
severity Subjective severity of condition Problems: Problems, Problems: SDOH Problems/Health Concerns

Because this profile is derived directly or indirectly from US Core, systems are also expected to support the Must Support and Additional USCDI requirements specified by the US Core profile this profile inherits from. For more information about those requirements, refer to the US Core Condition Problems and Health Concerns Profile. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... meta SΣ 0..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource last changed
... 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 (USCDI+ Quality) Date the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... clinicalStatus ?!SΣC 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept category codes
Slice: Unordered, Open by value:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core S 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
Binding: US Core Problem or Health Concern (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
Binding: US Core Simple Observation Category (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
Additional BindingsPurposeDocumentation
US Core Screening Assessment Condition Category Min Binding
Certifying Systems must support a category of "sdoh".

... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
... subject SΣ 1..1 Reference(US Quality Core Patient S | Group) Who has the condition?
... onset[x] SΣ 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] SC 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime S
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate SΣ 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder Σ 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) Who recorded the condition

doco 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.category:us-core Base required US Core Problem or Health Concern 📦9.0.0 US Core v9.0
Condition.category:screening-assessment Base required US Core Simple Observation Category 📦9.0.0 US Core v9.0
Condition.severity Base preferred Condition/Diagnosis Severity 📍4.0.1 FHIR Std.
Condition.code Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0

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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
... Slices for extension Content/Rules for all slices
.... extension:assertedDate 0..1 ConditionAssertedDate(5.3.0) (USCDI+ Quality) Date the condition was first asserted
... clinicalStatus 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
... category 1..* CodeableConcept category codes
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
... code 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
... subject 1..1 Reference(US Quality Core Patient | Group) Who has the condition?
... onset[x] 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) Who recorded the condition

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Condition.category Base extensible Condition Category Codes 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:assertedDate S 0..1 dateTime (USCDI+ Quality) Date the condition 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 ?!SΣC 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept category codes
Slice: Unordered, Open by value:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core S 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
Binding: US Core Problem or Health Concern (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
Binding: US Core Simple Observation Category (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
Additional BindingsPurposeDocumentation
US Core Screening Assessment Condition Category Min Binding
Certifying Systems must support a category of "sdoh".

... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... subject SΣ 1..1 Reference(US Quality Core Patient S | Group) Who has the condition?
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... onset[x] SΣ 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] SC 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime S
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate SΣ 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder Σ 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) 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 ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Condition.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
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.category:us-core Base required US Core Problem or Health Concern 📦9.0.0 US Core v9.0
Condition.category:screening-assessment Base required US Core Simple Observation Category 📦9.0.0 US Core v9.0
Condition.severity Base preferred Condition/Diagnosis Severity 📍4.0.1 FHIR Std.
Condition.code Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0
Condition.bodySite Base example SNOMED CT Body Structures 📍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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... meta SΣ 0..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource last changed
... 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 (USCDI+ Quality) Date the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... clinicalStatus ?!SΣC 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept category codes
Slice: Unordered, Open by value:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core S 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
Binding: US Core Problem or Health Concern (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
Binding: US Core Simple Observation Category (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
Additional BindingsPurposeDocumentation
US Core Screening Assessment Condition Category Min Binding
Certifying Systems must support a category of "sdoh".

... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
... subject SΣ 1..1 Reference(US Quality Core Patient S | Group) Who has the condition?
... onset[x] SΣ 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] SC 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime S
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate SΣ 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder Σ 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) Who recorded the condition

doco 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.category:us-core Base required US Core Problem or Health Concern 📦9.0.0 US Core v9.0
Condition.category:screening-assessment Base required US Core Simple Observation Category 📦9.0.0 US Core v9.0
Condition.severity Base preferred Condition/Diagnosis Severity 📍4.0.1 FHIR Std.
Condition.code Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
... Slices for extension Content/Rules for all slices
.... extension:assertedDate 0..1 ConditionAssertedDate(5.3.0) (USCDI+ Quality) Date the condition was first asserted
... clinicalStatus 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
... category 1..* CodeableConcept category codes
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
... code 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
... subject 1..1 Reference(US Quality Core Patient | Group) Who has the condition?
... onset[x] 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) Who recorded the condition

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Condition.category Base extensible Condition Category Codes 📦4.0.1 FHIR Std.

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* USCoreConditionProblemsHealthConcernsProfile(9.0.0) Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:assertedDate S 0..1 dateTime (USCDI+ Quality) Date the condition 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 ?!SΣC 0..1 CodeableConcept (USCDI+ Quality) active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept category codes
Slice: Unordered, Open by value:$this
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
.... category:us-core S 1..* CodeableConcept (USCDI+ Quality) problem-list-item | health-concern
Binding: US Core Problem or Health Concern (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
.... category:screening-assessment 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: USCDI Health Status/Assessments Data Class
Binding: US Core Simple Observation Category (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
Additional BindingsPurposeDocumentation
US Core Screening Assessment Condition Category Min Binding
Certifying Systems must support a category of "sdoh".

... severity 0..1 CodeableConcept (USCDI+ Quality) Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) Identification of the condition, problem or diagnosis
Binding: US Core Condition Codes (extensible): Valueset to describe the actual problem experienced by the patient
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... subject SΣ 1..1 Reference(US Quality Core Patient S | Group) Who has the condition?
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... onset[x] SΣ 0..1 (USCDI+ Quality) Estimated or actual date, date-time, or age
.... onsetDateTime dateTime S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... abatement[x] SC 0..1 (USCDI+ Quality) When in resolution/remission
.... abatementDateTime dateTime S
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
... recordedDate SΣ 0..1 dateTime (USCDI+ Quality) Date record was first recorded
... recorder Σ 0..1 Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) (USCDI+ Quality) 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 ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Condition.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
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.category:us-core Base required US Core Problem or Health Concern 📦9.0.0 US Core v9.0
Condition.category:screening-assessment Base required US Core Simple Observation Category 📦9.0.0 US Core v9.0
Condition.severity Base preferred Condition/Diagnosis Severity 📍4.0.1 FHIR Std.
Condition.code Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0
Condition.bodySite Base example SNOMED CT Body Structures 📍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()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Element Conformance Indicators by Profile Layer

Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.

Element conformance indicators organized by the profile layer where they are first introduced
Profile element FHIR US Core US Quality Core
meta Must Support
meta.lastUpdated Must Support
extension:assertedDate Must Support USCDI+ Quality
clinicalStatus Must Support USCDI+ Quality
verificationStatus Must Support
category Mandatory Must Support
category:us-core Mandatory Must Support USCDI+ Quality
category:screening-assessment Additional USCDI
severity USCDI+ Quality
code Mandatory Must Support USCDI+ Quality
subject Mandatory Must Support
onset[x] Must Support USCDI+ Quality
abatement[x] Must Support USCDI+ Quality
recordedDate Must Support USCDI+ Quality
recorder Additional USCDI USCDI+ Quality

Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.

Mandatory US Quality Core Server Search Parameters

The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.

Because this profile derives directly or indirectly from US Core, servers SHALL also support all mandatory searches described in the US Core Server CapabilityStatement requirements for Condition. When possible, this guide reuses mandatory searches from US Core and notes them with the EXISTING US CORE REQUIREMENT flag. While US Quality Core may restate US Core requirements to highlight searches directly relevant to USCDI+ Quality data access, US Core requirements not restated here remain applicable.

See the US Quality Core Server CapabilityStatement for complete requirements for the underlying Condition resource and Search Requirement Selection for how this focused set was selected.

Servers supporting this profile SHALL support the following search parameters and search parameter combinations:

  1. SHALL support searching for all Condition resources for a patient using the patient search parameter. EXISTING US CORE REQUIREMENT

    GET [base]/Condition?patient={Patient/}[id]

    Example:

    GET [base]/Condition?patient=Patient/example

    Implementation Notes: Fetches a bundle of US Quality Core Condition Problems Health Concerns resources matching the specified search criteria. See how to search by reference.

    Rationale for inclusion: Supports patient-scoped retrieval of Condition resources for USCDI+ Quality workflows.

  2. SHALL support searching for all Condition resources for a patient using the combination of the patient and category search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on category (e.g.category={system|}[search_code],{system|}[search_code],...).

    GET [base]/Condition?patient={Patient/}[id]&category={system|}[search_code]

    Example:

    GET [base]/Condition?patient=Patient/example&category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis

    Implementation Notes: Fetches a bundle of US Quality Core Condition Problems Health Concerns resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of Condition resources filtered by category for USCDI+ Quality workflows.

  3. SHALL support searching for all Condition resources for a patient using the combination of the patient and code search parameters.

    • Including optional support for OR search on code (e.g.code={system|}[search_code],{system|}[search_code],...).

    GET [base]/Condition?patient={Patient/}[id]&code={system|}[search_code]

    Example:

    GET [base]/Condition?patient=Patient/example&code=http://snomed.info/sct|74400008

    Implementation Notes: Fetches a bundle of US Quality Core Condition Problems Health Concerns resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of Condition resources filtered by code for USCDI+ Quality workflows.