International Patient Summary Implementation Guide
2.0.0 - STU 2 International flag

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

Resource Profile: ConditionUvIps - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the Condition-uv-ips resource profile.

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

0. Condition
Definition

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

ShortDocumentation of a health problem of the patientDetailed information about conditions, problems or diagnoses
Control0..*
Is Modifierfalse
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($this='problem-list-item').empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($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..1
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

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).

ShortExtensions 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..*
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|4.0.1)

The clinical status of the condition or diagnosis.

TypeCodeableConcept(Codeable Concept (IPS))
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
Obligations
    ObligationsActor
    SHALL:populate-if-knownCreator (IPS)
    SHALL:handleConsumer (IPS)
    SHOULD:displayConsumer (IPS)
    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.

    Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
    Comments

    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.


    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 ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

    The verification status to support or decline the clinical status of the condition or diagnosis.

    TypeCodeableConcept(Codeable Concept (IPS))
    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.
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Condition.category
    Definition

    A category assigned to the condition. In this profile, a health problem of the patient, therefore a 'problem-list-item'.


    A category assigned to the condition.

    Shortproblem-list-item | encounter-diagnosis
    Comments

    In this profile, Condition represents a health problem of the patient. Therefore one of the category value(s) must be problem-list-item.


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

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from Problem Type - IPShttp://hl7.org/fhir/ValueSet/condition-category
    (extensible to http://hl7.org/fhir/uv/ips/ValueSet/problem-type-uv-ips)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:populate-if-knownCreator (IPS)
      SHALL:handleConsumer (IPS)
      SHOULD:displayConsumer (IPS)
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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/DiagnosisSeverityhttp://hl7.org/fhir/ValueSet/condition-severity
      (preferred to http://hl7.org/fhir/ValueSet/condition-severity)
      TypeCodeableConcept(Codeable Concept (IPS))
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:populate-if-knownCreator (IPS)
        SHALL:handleConsumer (IPS)
        SHOULD:displayConsumer (IPS)
        Summaryfalse
        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 or recording of absent/unknown problems.


        Identification of the condition, problem or diagnosis.

        ShortIdentification of the condition, problem or diagnosis
        Control10..1
        BindingThe codes SHOULD be taken from For example codes, see Problems - IPShttp://hl7.org/fhir/ValueSet/condition-code
        (preferred to http://hl7.org/fhir/uv/ips/ValueSet/problems-uv-ips)

        Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT


        Identification of the condition or diagnosis.

        TypeCodeableConcept(Codeable Concept (IPS))
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:populate-if-knownCreator (IPS)
          SHALL:handleConsumer (IPS)
          SHOULD:displayConsumer (IPS)
          Summarytrue
          Requirements

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

          Alternate Namestype
          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..*
          BindingThe codes SHOULD be taken from For example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site
          (preferred to http://hl7.org/fhir/ValueSet/body-site)
          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(Patient (IPS), Patient, Group)
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:populate-if-knownCreator (IPS)
            SHALL:handleConsumer (IPS)
            SHOULD:displayConsumer (IPS)
            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.subject.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control10..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-knownCreator (IPS)
              SHALL:handleConsumer (IPS)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. 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, Age, Period, Range, string
              [x] NoteSeeChoice of Data Typesfor 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 TypesNo must-support rules about the choice of types/profiles
              Obligations
                ObligationsActor
                SHALL:populate-if-knownCreator (IPS)
                SHALL:handleConsumer (IPS)
                SHOULD:displayConsumer (IPS)
                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.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 24. Condition.onset[x]:onsetDateTime
                  Slice NameonsetDateTime
                  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
                  TypedateTime, string, Period, Range, Age
                  [x] NoteSeeChoice of Data Typesfor 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
                  Obligations
                    ObligationsActor
                    SHOULD:able-to-populateCreator (IPS)
                    SHALL:handleConsumer (IPS)
                    SHOULD:displayConsumer (IPS)
                    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 foundhere

                    0. Condition
                    ShortDocumentation of a health problem of the patient
                    2. Condition.clinicalStatus
                    TypeCodeableConcept(Codeable Concept (IPS))
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownCreator (IPS)
                      SHALL:handleConsumer (IPS)
                      SHOULD:displayConsumer (IPS)
                      4. Condition.verificationStatus
                      Comments

                      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.

                      TypeCodeableConcept(Codeable Concept (IPS))
                      6. Condition.category
                      Definition

                      A category assigned to the condition. In this profile, a health problem of the patient, therefore a 'problem-list-item'.

                      Comments

                      In this profile, Condition represents a health problem of the patient. Therefore one of the category value(s) must be problem-list-item.

                      BindingUnless not suitable, these codes SHALL be taken from Problem Type - IPS
                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/problem-type-uv-ips)
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownCreator (IPS)
                        SHALL:handleConsumer (IPS)
                        SHOULD:displayConsumer (IPS)
                        8. Condition.severity
                        BindingThe codes SHOULD be taken from Condition/DiagnosisSeverity
                        (preferred to http://hl7.org/fhir/ValueSet/condition-severity)
                        TypeCodeableConcept(Codeable Concept (IPS))
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownCreator (IPS)
                          SHALL:handleConsumer (IPS)
                          SHOULD:displayConsumer (IPS)
                          10. Condition.code
                          Definition

                          Identification of the condition, problem or diagnosis or recording of absent/unknown problems.

                          Control1..?
                          BindingThe codes SHOULD be taken from Problems - IPS
                          (preferred to http://hl7.org/fhir/uv/ips/ValueSet/problems-uv-ips)

                          Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT

                          TypeCodeableConcept(Codeable Concept (IPS))
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownCreator (IPS)
                            SHALL:handleConsumer (IPS)
                            SHOULD:displayConsumer (IPS)
                            12. Condition.bodySite
                            BindingThe codes SHOULD be taken from SNOMEDCTBodyStructures
                            (preferred to http://hl7.org/fhir/ValueSet/body-site)
                            14. Condition.subject
                            TypeReference(Patient (IPS))
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownCreator (IPS)
                              SHALL:handleConsumer (IPS)
                              SHOULD:displayConsumer (IPS)
                              16. Condition.subject.reference
                              Control1..?
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownCreator (IPS)
                                SHALL:handleConsumer (IPS)
                                18. Condition.onset[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownCreator (IPS)
                                  SHALL:handleConsumer (IPS)
                                  SHOULD:displayConsumer (IPS)
                                  SlicingThis element introduces a set of slices on Condition.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 20. Condition.onset[x]:onsetDateTime
                                    Slice NameonsetDateTime
                                    Control0..1
                                    TypedateTime
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHOULD:able-to-populateCreator (IPS)
                                      SHALL:handleConsumer (IPS)
                                      SHOULD:displayConsumer (IPS)

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

                                      0. Condition
                                      Definition

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

                                      ShortDocumentation of a health problem of the patient
                                      Control0..*
                                      Is Modifierfalse
                                      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())
                                      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..1
                                      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

                                      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).

                                      ShortExtensions 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..*
                                      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())
                                      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|4.0.1)

                                      The clinical status of the condition or diagnosis.

                                      TypeCodeableConcept(Codeable Concept (IPS))
                                      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
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownCreator (IPS)
                                        SHALL:handleConsumer (IPS)
                                        SHOULD:displayConsumer (IPS)
                                        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.

                                        Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
                                        Comments

                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: con-3, con-5
                                        BindingThe codes SHALL be taken from ConditionVerificationStatus
                                        (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

                                        The verification status to support or decline the clinical status of the condition or diagnosis.

                                        TypeCodeableConcept(Codeable Concept (IPS))
                                        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.
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        24. Condition.category
                                        Definition

                                        A category assigned to the condition. In this profile, a health problem of the patient, therefore a 'problem-list-item'.

                                        Shortproblem-list-item | encounter-diagnosis
                                        Comments

                                        In this profile, Condition represents a health problem of the patient. Therefore one of the category value(s) must be problem-list-item.

                                        Control0..*
                                        BindingUnless not suitable, these codes SHALL be taken from Problem Type - IPS
                                        (extensible to http://hl7.org/fhir/uv/ips/ValueSet/problem-type-uv-ips)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownCreator (IPS)
                                          SHALL:handleConsumer (IPS)
                                          SHOULD:displayConsumer (IPS)
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          26. 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)
                                          TypeCodeableConcept(Codeable Concept (IPS))
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownCreator (IPS)
                                            SHALL:handleConsumer (IPS)
                                            SHOULD:displayConsumer (IPS)
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            28. Condition.code
                                            Definition

                                            Identification of the condition, problem or diagnosis or recording of absent/unknown problems.

                                            ShortIdentification of the condition, problem or diagnosis
                                            Control1..1
                                            BindingThe codes SHOULD be taken from Problems - IPS
                                            (preferred to http://hl7.org/fhir/uv/ips/ValueSet/problems-uv-ips)

                                            Code for a clinical problem (or absent/unknown problem) that is selected from SNOMED CT

                                            TypeCodeableConcept(Codeable Concept (IPS))
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownCreator (IPS)
                                              SHALL:handleConsumer (IPS)
                                              SHOULD:displayConsumer (IPS)
                                              Summarytrue
                                              Requirements

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

                                              Alternate Namestype
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              30. 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..*
                                              BindingThe codes SHOULD be taken from SNOMEDCTBodyStructures
                                              (preferred to http://hl7.org/fhir/ValueSet/body-site)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              32. Condition.subject
                                              Definition

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

                                              ShortWho has the condition?
                                              Control1..1
                                              TypeReference(Patient (IPS))
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownCreator (IPS)
                                                SHALL:handleConsumer (IPS)
                                                SHOULD:displayConsumer (IPS)
                                                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()))
                                                34. Condition.subject.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
                                                36. Condition.subject.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())
                                                SlicingThis element introduces a set of slices on Condition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 38. Condition.subject.reference
                                                  Definition

                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                  Comments

                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                  Control1..1
                                                  This element is affected by the following invariants: ref-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownCreator (IPS)
                                                    SHALL:handleConsumer (IPS)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    40. Condition.subject.type
                                                    Definition

                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                    ShortType the reference refers to (e.g. "Patient")
                                                    Comments

                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                    Control0..1
                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                    Typeuri
                                                    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()))
                                                    42. Condition.subject.identifier
                                                    Definition

                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                    ShortLogical reference, when literal reference is not known
                                                    Comments

                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                    Control0..1
                                                    TypeIdentifier
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    44. Condition.subject.display
                                                    Definition

                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                    ShortText alternative for the resource
                                                    Comments

                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                    Control0..1
                                                    Typestring
                                                    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()))
                                                    46. 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()))
                                                    48. 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, Age, Period, Range, string
                                                    [x] NoteSeeChoice of Data Typesfor 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 TypesNo must-support rules about the choice of types/profiles
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populate-if-knownCreator (IPS)
                                                      SHALL:handleConsumer (IPS)
                                                      SHOULD:displayConsumer (IPS)
                                                      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.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • type @ $this
                                                      • 50. Condition.onset[x]:onsetDateTime
                                                        Slice NameonsetDateTime
                                                        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
                                                        TypedateTime
                                                        [x] NoteSeeChoice of Data Typesfor 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
                                                        Obligations
                                                          ObligationsActor
                                                          SHOULD:able-to-populateCreator (IPS)
                                                          SHALL:handleConsumer (IPS)
                                                          SHOULD:displayConsumer (IPS)
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          52. 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, Age, Period, Range, string
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          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()))
                                                          54. 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()))
                                                          56. 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()))
                                                          58. Condition.asserter
                                                          Definition

                                                          Individual who is making the condition statement.

                                                          ShortPerson who asserts this 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()))
                                                          60. Condition.stage
                                                          Definition

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

                                                          ShortStage/grade, usually assessed formally
                                                          Control0..*
                                                          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()))
                                                          62. Condition.stage.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
                                                          64. Condition.stage.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())
                                                          66. Condition.stage.modifierExtension
                                                          Definition

                                                          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).

                                                          ShortExtensions 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..*
                                                          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())
                                                          68. Condition.stage.summary
                                                          Definition

                                                          A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

                                                          ShortSimple summary (disease specific)
                                                          Control0..1
                                                          This element is affected by the following invariants: con-1
                                                          BindingFor example codes, see ConditionStage
                                                          (example to http://hl7.org/fhir/ValueSet/condition-stage)

                                                          Codes describing condition stages (e.g. Cancer stages).

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

                                                          Reference to a formal record of the evidence on which the staging assessment is based.

                                                          ShortFormal record of assessment
                                                          Control0..*
                                                          This element is affected by the following invariants: con-1
                                                          TypeReference(ClinicalImpression, DiagnosticReport, Observation)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          72. Condition.stage.type
                                                          Definition

                                                          The kind of staging, such as pathological or clinical staging.

                                                          ShortKind of staging
                                                          Control0..1
                                                          BindingFor example codes, see ConditionStageType
                                                          (example to http://hl7.org/fhir/ValueSet/condition-stage-type)

                                                          Codes describing the kind of condition staging (e.g. clinical or pathological).

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          74. 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
                                                          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()))
                                                          76. 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
                                                          78. 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())
                                                          80. Condition.evidence.modifierExtension
                                                          Definition

                                                          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).

                                                          ShortExtensions 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..*
                                                          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())
                                                          82. 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()))
                                                          84. 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()))
                                                          86. 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()))