Physical Activity Implementation Guide
1.0.1 - STU Release 1 United States of America flag

Physical Activity Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/physical-activity/ and changes regularly. See the Directory of published versions

Resource Profile: PAConditionLowPA - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the pa-condition-low-pa resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Condition
Definition

A condition that conveys the fact that a patient has a clinically significant and insufficient level of physical activity

2. Condition.implicitRules
Control0..0
4. Condition.modifierExtension
Control0..0
6. Condition.verificationStatus
Shortconfirmed | refuted | entered-in-error
BindingThe codes SHALL be taken from PA Condition Verification Status
(required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-condition-verification-status)
8. Condition.category
Definition

Category codes related to the condition. This element is intended to allow inclusion of any of the three codes from the US Core Condition Category codes or other extensibly identified existing concepts. However, in addition to these, a coding instance with the temporary code 'PhysicalActivity' should be included in this category.

Control2..?
SlicingThis element introduces a set of slices on Condition.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 10. Condition.category:PA
    Slice NamePA
    ShortAdditional category indicating the condition is related to physical activity
    Control1..1
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
        "code" : "PhysicalActivity"
      }]
    }
    12. Condition.code
    ShortLack of physical exercise
    Pattern Value{
      "coding" : [{
        "system" : "http://hl7.org/fhir/sid/icd-10-cm",
        "code" : "Z72.3",
        "display" : "Lack of physical exercise"
      }]
    }
    14. Condition.bodySite
    Control0..0
    16. Condition.onset[x]
    TypeChoice of: dateTime, Period, string, Range, Age
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Must Support TypesdateTime
    18. Condition.abatement[x]
    TypeChoice of: dateTime, Period, string, Range, Age
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Must Support TypesdateTime
    20. Condition.asserter
    TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile)
    Must Supporttrue
    Must Support TypesReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
    22. Condition.stage
    Control0..0
    24. Condition.evidence
    Must Supporttrue
    26. Condition.evidence.modifierExtension
    Control0..0
    28. Condition.evidence.detail
    SlicingThis element introduces a set of slices on Condition.evidence.detail. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 30. Condition.evidence.detail:SupportedDetail
      Slice NameSupportedDetail
      Comments

      ... A variety of resources might provide support for asserting this condition, however at minimum, systems must support the Physical Activity Vital Sign observations.

      Control0..*
      TypeReference(Reference - RESTful)(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week, PA Observation - EVS, Minutes/Week, PA Observation - EVS, Strength Days/Week)
      Must Supporttrue
      Must Support TypesReference(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week)

      Guidance on how to interpret the contents of this table can be found here

      0. Condition
      Definition

      A condition that conveys the fact that a patient has a clinically significant and insufficient level of physical activity


      A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

      ShortDetailed information about conditions, problems or diagnoses
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantscon-3: 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: 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: 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: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. (where(category.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category')).exists())
      con-3: 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: 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: 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())
      2. Condition.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..01
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Condition.modifierExtension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensionExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      6. Condition.clinicalStatus
      Definition

      The clinical status of the condition.

      Shortactive | recurrence | relapse | inactive | remission | resolved
      Comments

      The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

      Control0..1
      This element is affected by the following invariants: con-3, con-4, con-5
      BindingThe codes SHALL be taken from ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
      (required to http://hl7.org/fhir/ValueSet/condition-clinical)
      TypeCodeableConcept
      Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Condition.verificationStatus
      Definition

      The verification status to support the clinical status of the condition.

      Shortconfirmed | refuted | entered-in-errorunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
      Comments

      verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

      Control0..1
      This element is affected by the following invariants: con-3, con-5
      BindingThe codes SHALL be taken from PA Condition Verification Statushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
      (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-condition-verification-status)
      TypeCodeableConcept
      Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Condition.category
      Definition

      Category codes related to the condition. This element is intended to allow inclusion of any of the three codes from the US Core Condition Category codes or other extensibly identified existing concepts. However, in addition to these, a coding instance with the temporary code 'PhysicalActivity' should be included in this category.


      A category assigned to the condition.

      Shortproblem-list-item | encounter-diagnosis | health-concern
      Comments

      The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

      Control20..*
      This element is affected by the following invariants: us-core-1
      BindingUnless not suitable, these codes SHALL be taken from US Core Condition Category Codeshttp://hl7.org/fhir/ValueSet/condition-category
      (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Condition.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 12. Condition.category:PA
        Slice NamePA
        Definition

        A category assigned to the condition.

        ShortAdditional category indicating the condition is related to physical activityproblem-list-item | encounter-diagnosis
        Comments

        The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

        Control10..1*
        This element is affected by the following invariants: us-core-1
        BindingUnless not suitable, these codes SHALL be taken from US Core Condition Category Codeshttp://hl7.org/fhir/ValueSet/condition-category
        (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Pattern Value{
          "coding" : [{
            "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
            "code" : "PhysicalActivity"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. Condition.code
        Definition

        Identification of the condition, problem or diagnosis.

        ShortLack of physical exerciseIdentification of the condition, problem or diagnosis
        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see US Core Condition Codehttp://hl7.org/fhir/ValueSet/condition-code
        (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)

        Valueset to describe the actual problem experienced by the patient


        Identification of the condition or diagnosis.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        0..1 to account for primarily narrative only resources.

        Alternate Namestype
        Pattern Value{
          "coding" : [{
            "system" : "http://hl7.org/fhir/sid/icd-10-cm",
            "code" : "Z72.3",
            "display" : "Lack of physical exercise"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Condition.bodySite
        Definition

        The anatomical location where this condition manifests itself.

        ShortAnatomical location, if relevant
        Comments

        Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

        Control0..0*
        BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site
        (example to http://hl7.org/fhir/ValueSet/body-site)

        Codes describing anatomical locations. May include laterality.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Condition.subject
        Definition

        Indicates the patient or group who the condition record is associated with.

        ShortWho has the condition?
        Control1..1
        TypeReference(US Core Patient Profile, Patient, Group)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Group is typically used for veterinary or public health use cases.

        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Condition.onset[x]
        Definition

        Estimated or actual date or date-time the condition began, in the opinion of the clinician.

        ShortEstimated or actual date, date-time, or age
        Comments

        Age is generally used when the patient reports an age at which the Condition began to occur.

        Control0..1
        TypeChoice of: dateTime, Period, string, Range, Age
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Must Support TypesdateTime
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Condition.abatement[x]
        Definition

        The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

        ShortWhen in resolution/remission
        Comments

        There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

        Control0..1
        This element is affected by the following invariants: con-4
        TypeChoice of: dateTime, Period, string, Range, Age
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Must Support TypesdateTime
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Condition.asserter
        Definition

        Individual who is making the condition statement.

        ShortPerson who asserts this condition
        Control0..1
        TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile, Practitioner, PractitionerRole, Patient, RelatedPerson)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Condition.stage
        Definition

        Clinical stage or grade of a condition. May include formal severity assessments.

        ShortStage/grade, usually assessed formally
        Control0..0*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantscon-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
        29. Condition.evidence
        Definition

        Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

        ShortSupporting evidence
        Comments

        The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantscon-2: evidence SHALL have code or details (code.exists() or detail.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        con-2: evidence SHALL have code or details (code.exists() or detail.exists())
        31. Condition.evidence.modifierExtension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensionExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        33. Condition.evidence.detail
        Definition

        Links to other relevant information, including pathology reports.

        ShortSupporting information found elsewhere
        Control0..*
        This element is affected by the following invariants: con-2
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Condition.evidence.detail. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 35. Condition.evidence.detail:SupportedDetail
          Slice NameSupportedDetail
          Definition

          Links to other relevant information, including pathology reports.

          ShortSupporting information found elsewhere
          Comments

          A variety of resources might provide support for asserting this condition, however at minimum, systems must support the Physical Activity Vital Sign observations.

          Control0..*
          This element is affected by the following invariants: con-2
          TypeReference(Reference - RESTful)(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week, PA Observation - EVS, Minutes/Week, PA Observation - EVS, Strength Days/Week, Resource)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesReference(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be found here

          0. Condition
          Definition

          A condition that conveys the fact that a patient has a clinically significant and insufficient level of physical activity

          ShortDetailed information about conditions, problems or diagnoses
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantscon-3: 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: 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: 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: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. (where(category.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category')).exists())
          2. Condition.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. Condition.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Condition.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..0
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Condition.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Condition.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Condition.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Condition.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. Condition.modifierExtension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. Condition.identifier
          Definition

          Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

          ShortExternal Ids for this condition
          Comments

          This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. Condition.clinicalStatus
          Definition

          The clinical status of the condition.

          Shortactive | recurrence | relapse | inactive | remission | resolved
          Comments

          The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

          Control0..1
          This element is affected by the following invariants: con-3, con-4, con-5
          BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
          (required to http://hl7.org/fhir/ValueSet/condition-clinical)
          TypeCodeableConcept
          Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Condition.verificationStatus
          Definition

          The verification status to support the clinical status of the condition.

          Shortconfirmed | refuted | entered-in-error
          Comments

          verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

          Control0..1
          This element is affected by the following invariants: con-3, con-5
          BindingThe codes SHALL be taken from PA Condition Verification Status
          (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-condition-verification-status)
          TypeCodeableConcept
          Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Condition.category
          Definition

          Category codes related to the condition. This element is intended to allow inclusion of any of the three codes from the US Core Condition Category codes or other extensibly identified existing concepts. However, in addition to these, a coding instance with the temporary code 'PhysicalActivity' should be included in this category.

          Shortproblem-list-item | encounter-diagnosis | health-concern
          Comments

          The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

          Control2..*
          This element is affected by the following invariants: us-core-1
          BindingUnless not suitable, these codes SHALL be taken from US Core Condition Category Codes
          (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Condition.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • pattern @ $this
          • 26. Condition.category:PA
            Slice NamePA
            Definition

            A category assigned to the condition.

            ShortAdditional category indicating the condition is related to physical activity
            Comments

            The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

            Control1..1
            This element is affected by the following invariants: us-core-1
            BindingUnless not suitable, these codes SHALL be taken from US Core Condition Category Codes
            (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
                "code" : "PhysicalActivity"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Condition.severity
            Definition

            A subjective assessment of the severity of the condition as evaluated by the clinician.

            ShortSubjective severity of condition
            Comments

            Coding of the severity with a terminology is preferred, where possible.

            Control0..1
            BindingThe codes SHOULD be taken from Condition/DiagnosisSeverity
            (preferred to http://hl7.org/fhir/ValueSet/condition-severity)

            A subjective assessment of the severity of the condition as evaluated by the clinician.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Condition.code
            Definition

            Identification of the condition, problem or diagnosis.

            ShortLack of physical exercise
            Control1..1
            BindingUnless not suitable, these codes SHALL be taken from US Core Condition Code
            (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)

            Valueset to describe the actual problem experienced by the patient

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            0..1 to account for primarily narrative only resources.

            Alternate Namestype
            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/sid/icd-10-cm",
                "code" : "Z72.3",
                "display" : "Lack of physical exercise"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Condition.bodySite
            Definition

            The anatomical location where this condition manifests itself.

            ShortAnatomical location, if relevant
            Comments

            Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

            Control0..0
            BindingFor example codes, see SNOMEDCTBodyStructures
            (example to http://hl7.org/fhir/ValueSet/body-site)

            Codes describing anatomical locations. May include laterality.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Condition.subject
            Definition

            Indicates the patient or group who the condition record is associated with.

            ShortWho has the condition?
            Control1..1
            TypeReference(US Core Patient Profile)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Group is typically used for veterinary or public health use cases.

            Alternate Namespatient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Condition.encounter
            Definition

            The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

            ShortEncounter created as part of
            Comments

            This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

            Control0..1
            TypeReference(Encounter)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Condition.onset[x]
            Definition

            Estimated or actual date or date-time the condition began, in the opinion of the clinician.

            ShortEstimated or actual date, date-time, or age
            Comments

            Age is generally used when the patient reports an age at which the Condition began to occur.

            Control0..1
            TypeChoice of: dateTime, Period
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesdateTime
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Condition.abatement[x]
            Definition

            The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

            ShortWhen in resolution/remission
            Comments

            There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

            Control0..1
            This element is affected by the following invariants: con-4
            TypeChoice of: dateTime, Period
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesdateTime
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Condition.recordedDate
            Definition

            The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

            ShortDate record was first recorded
            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Condition.recorder
            Definition

            Individual who recorded the record and takes responsibility for its content.

            ShortWho recorded the condition
            Control0..1
            TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. Condition.asserter
            Definition

            Individual who is making the condition statement.

            ShortPerson who asserts this condition
            Control0..1
            TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Condition.stage
            Definition

            Clinical stage or grade of a condition. May include formal severity assessments.

            ShortStage/grade, usually assessed formally
            Control0..0
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantscon-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Condition.evidence
            Definition

            Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

            ShortSupporting evidence
            Comments

            The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantscon-2: evidence SHALL have code or details (code.exists() or detail.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Condition.evidence.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            60. Condition.evidence.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            62. Condition.evidence.modifierExtension
            Definition

            An Extension

            ShortExtension
            Control0..0
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            64. Condition.evidence.code
            Definition

            A manifestation or symptom that led to the recording of this condition.

            ShortManifestation/symptom
            Control0..*
            This element is affected by the following invariants: con-2
            BindingFor example codes, see ManifestationAndSymptomCodes
            (example to http://hl7.org/fhir/ValueSet/manifestation-or-symptom)

            Codes that describe the manifestation or symptoms of a condition.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Condition.evidence.detail
            Definition

            Links to other relevant information, including pathology reports.

            ShortSupporting information found elsewhere
            Control0..*
            This element is affected by the following invariants: con-2
            TypeReference(Resource)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Condition.evidence.detail. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 68. Condition.evidence.detail:SupportedDetail
              Slice NameSupportedDetail
              Definition

              Links to other relevant information, including pathology reports.

              ShortSupporting information found elsewhere
              Comments

              A variety of resources might provide support for asserting this condition, however at minimum, systems must support the Physical Activity Vital Sign observations.

              Control0..*
              This element is affected by the following invariants: con-2
              TypeReference(Reference - RESTful)(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week, PA Observation - EVS, Minutes/Week, PA Observation - EVS, Strength Days/Week)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesReference(PA Observation - EVS, Minutes/Day, PA Observation - EVS, Days/Week)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Condition.note
              Definition

              Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

              ShortAdditional information about the Condition
              Control0..*
              TypeAnnotation
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))