UV_Vital Records Birth and Fetal Death Reporting
1.1.0 - STU 1.1

UV_Vital Records Birth and Fetal Death Reporting, published by IHE International. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/fhir-bfdr/ and changes regularly. See the Directory of published versions

## Resource Profile: Condition - Infection Present During Pregnancy

Official URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-infection-present-during-pregnancy | Version: 1.1.0
Active as of 2024-07-09 | Computable Name: ConditionInfectionPresentDuringPregnancy

This Condition profile represents infections present and/or treated during the pregnancy.

This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record.

### Form Mapping

This profile is mapped to:

- Item 42. Infections present and/or treated during this pregnancy in the 2003 Revision of the U.S. Standard Certificate of Live Birth
- Item 15. Infections present and/or treated during this pregnancy in the 2016 US Standard Facility Worksheet for the Live Birth Certificate

### IJE Mapping

Use Case | IJE Field# | Description | IJE Name | Field
--- | --- | --- | --- | ---
Natality | 171 | Infections Present–Chlamydia | CHAM |
Natality | 168 | Infections Present–Gonorrhea | GON |
Natality | 172 | Infections Present–Hepatitis B | HEPB |
Natality | 173 | Infections Present–Hepatitis C | HEPC |
Natality | 169 | Infections Present–Syphilis | SYPH |

Usage:

- Refer to this Resource Profile: Composition - Jurisdiction Live Birth Report and Composition - Provider Live Birth Report
- Examples for this Resource Profile: Condition/condition-infection-present-during-pregnancy-jada-ann-quinn

### Formal Views of Profile Content

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

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

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition |  | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record.
category |  | 2..* | CodeableConcept | category codes
Slices for category |  |  |  | Content/Rules for all slices
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
code |  | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
subject |  | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record. con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 2..* | CodeableConcept | category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required)
category:sdoh | S | 0..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: sdoh
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
code | S Σ | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
subject | S Σ | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
onset[x] | S Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
abatement[x] | S C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical` from the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status` from the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:us-core | required | USCoreProblemOrHealthConcern `http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern`
Condition.category:sdoh | extensible | Pattern: sdoh `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:infectionDuringPregnancy | extensible | Pattern: LOINC Code 72519-2 `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item : clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty() |
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists() |
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Condition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Condition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record. con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
assertedDate | S | 0..1 | dateTime | 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 | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 2..* | CodeableConcept | category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required)
category:sdoh | S | 0..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: sdoh
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
severity |  | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the condition
asserter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Person who asserts this condition
stage | C | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
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 con-2: evidence SHALL have code or details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Condition.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
`http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical` from the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status` from the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:us-core | required | USCoreProblemOrHealthConcern `http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern`
Condition.category:sdoh | extensible | Pattern: sdoh `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:infectionDuringPregnancy | extensible | Pattern: LOINC Code 72519-2 `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.severity | preferred | Condition/DiagnosisSeverity `http://hl7.org/fhir/ValueSet/condition-severity` from the FHIR Standard
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`
Condition.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Condition.stage.summary | example | ConditionStage `http://hl7.org/fhir/ValueSet/condition-stage` from the FHIR Standard
Condition.stage.type | example | ConditionStageType `http://hl7.org/fhir/ValueSet/condition-stage-type` from the FHIR Standard
Condition.evidence.code | example | ManifestationAndSymptomCodes `http://hl7.org/fhir/ValueSet/manifestation-or-symptom` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
con-1 | error | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() |
con-2 | error | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item : clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty() |
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists() |
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Condition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Condition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Patient - Mother - Vital Records (http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr)

Differential View

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition |  | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record.
category |  | 2..* | CodeableConcept | category codes
Slices for category |  |  |  | Content/Rules for all slices
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
code |  | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
subject |  | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record. con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
assertedDate | S | 0..1 | dateTime | Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 2..* | CodeableConcept | category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required)
category:sdoh | S | 0..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: sdoh
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
code | S Σ | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
subject | S Σ | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
onset[x] | S Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
abatement[x] | S C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical` from the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status` from the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:us-core | required | USCoreProblemOrHealthConcern `http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern`
Condition.category:sdoh | extensible | Pattern: sdoh `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:infectionDuringPregnancy | extensible | Pattern: LOINC Code 72519-2 `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile | Information on infections present and/or treated during the pregnancy. This includes infections present at the start of pregnancy or confirmed diagnosis during pregnancy with or without documentation of treatment. Documentation of treatment during this pregnancy is adequate if a definitive diagnosis is not present in the available record. con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
assertedDate | S | 0..1 | dateTime | 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 | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 2..* | CodeableConcept | category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | problem-list-item | health-concern Binding: US Core Problem or Health Concern (required)
category:sdoh | S | 0..1 | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-tags
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: sdoh
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category:infectionDuringPregnancy | S | 1..1 | CodeableConcept | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 72519-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
severity |  | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 1..1 | CodeableConcept | Infections present and/or treated during this pregnancy for live birth as required by the National US Standards. Note: Genital herpes simplex (SNOMED code 33839006) is only a Michigan state-specific requirement. Binding: Infections During Pregnancy - Live Birth (NCHS) (required): Infections During Pregnancy - Live Birth (NCHS)
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(Patient - Mother - Vital Records) | Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | Date record was first recorded
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the condition
asserter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Person who asserts this condition
stage | C | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
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 con-2: evidence SHALL have code or details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Condition.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
`http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical` from the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status` from the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:us-core | required | USCoreProblemOrHealthConcern `http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern`
Condition.category:sdoh | extensible | Pattern: sdoh `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.category:infectionDuringPregnancy | extensible | Pattern: LOINC Code 72519-2 `http://hl7.org/fhir/ValueSet/condition-category` from the FHIR Standard
Condition.severity | preferred | Condition/DiagnosisSeverity `http://hl7.org/fhir/ValueSet/condition-severity` from the FHIR Standard
Condition.code | required | PHVS_InfectionsDuringPregnancyLiveBirth_NCHS `http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.6070`
Condition.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
Condition.stage.summary | example | ConditionStage `http://hl7.org/fhir/ValueSet/condition-stage` from the FHIR Standard
Condition.stage.type | example | ConditionStageType `http://hl7.org/fhir/ValueSet/condition-stage-type` from the FHIR Standard
Condition.evidence.code | example | ManifestationAndSymptomCodes `http://hl7.org/fhir/ValueSet/manifestation-or-symptom` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
con-1 | error | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() |
con-2 | error | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item : clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty() |
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists() |
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Condition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Condition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Patient - Mother - Vital Records (http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr)

Other representations of profile: CSV, Excel, Schematron