PH eReferral Implementation Guide
0.1.0 - ci-build Philippines flag

PH eReferral Implementation Guide, published by SILab CoP IG Accelerator (eReferral). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jldalisay95/ph-ereferral-jld/ and changes regularly. See the Directory of published versions

Resource Profile: EReferral Condition - Detailed Descriptions

Draft as of 2026-05-02

Definitions for the ereferral-condition 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.

ShortDetailed 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 current clinical status of the diagnosis, problem, or condition relevant to the referral.


The clinical status of the condition.

ShortClinical status of the conditionactive | 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
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
    ObligationsActorSource
    SHALL:handlePH Core Serverfrom PH Core Condition
    SHALL:handlePH Core Consumerfrom PH Core Condition
    MAY:able-to-populatePH Core Creatorfrom PH Core Condition
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Condition.clinicalStatus.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActorSource
      SHALL:handlePH Core Serverfrom PH Core Condition
      SHALL:handlePH Core Consumerfrom PH Core Condition
      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

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

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Obligations
        ObligationsActorSource
        SHALL:handlePH Core Serverfrom PH Core Condition
        SHALL:handlePH Core Consumerfrom PH Core Condition
        MAY:able-to-populatePH Core Creatorfrom PH Core Condition
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

        The certainty or verification state for the diagnosis, problem, or condition, such as provisional or confirmed.


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

        ShortVerification status of the conditionunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
        Comments

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

        Control0..1
        This element is affected by the following invariants: con-3, con-5
        BindingThe codes SHALL be taken from 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
        Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
        Must Supporttrue
        Obligations
          ObligationsActorSource
          SHALL:handlePH Core Serverfrom PH Core Condition
          SHALL:handlePH Core Consumerfrom PH Core Condition
          MAY:able-to-populatePH Core Creatorfrom PH Core Condition
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Condition.verificationStatus.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActorSource
            SHALL:handlePH Core Serverfrom PH Core Condition
            SHALL:handlePH Core Consumerfrom PH Core Condition
            MAY:able-to-populatePH Core Creatorfrom PH Core Condition
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

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

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActorSource
              SHALL:handlePH Core Serverfrom PH Core Condition
              SHALL:handlePH Core Consumerfrom PH Core Condition
              MAY:able-to-populatePH Core Creatorfrom PH Core Condition
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

              Categorizes the condition as a problem list item, encounter diagnosis, or other category supported by the inherited PH Core binding.


              A category assigned to the condition.

              ShortCondition categoryproblem-list-item | encounter-diagnosis
              Comments

              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 ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-category|4.0.1
              (extensible to http://hl7.org/fhir/ValueSet/condition-category|4.0.1)

              A category assigned to the condition.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. 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|4.0.1
              (preferred to http://hl7.org/fhir/ValueSet/condition-severity|4.0.1)

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

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

              The coded diagnosis, problem, symptom, or clinical condition that is relevant to the eReferral request.


              Identification of the condition, problem or diagnosis.

              ShortDiagnosis, problem, or conditionIdentification of the condition, problem or diagnosis
              Control0..1
              BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
              (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

              Identification of the condition or diagnosis.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              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()))
              24. Condition.code.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

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

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. 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..*
              BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1
              (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

              Codes describing anatomical locations. May include laterality.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActorSource
                SHALL:handlePH Core Serverfrom PH Core Condition
                SHALL:handlePH Core Consumerfrom PH Core Condition
                MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. Condition.bodySite.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActorSource
                  SHALL:handlePH Core Serverfrom PH Core Condition
                  SHALL:handlePH Core Consumerfrom PH Core Condition
                  MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

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

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Obligations
                    ObligationsActorSource
                    SHALL:handlePH Core Serverfrom PH Core Condition
                    SHALL:handlePH Core Consumerfrom PH Core Condition
                    MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                    Summarytrue
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                    The patient who has the diagnosis, problem, or clinical condition relevant to the referral.


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

                    ShortPatient with the conditionWho has the condition?
                    Control1..1
                    TypeReference(PH Core Patient, Patient, Group)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

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

                    ShortEncounter created as part of
                    Comments

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

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

                    The estimated or known date, date/time, age, period, range, or text describing when the condition began.


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

                    ShortCondition onsetEstimated 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
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    40. Condition.recordedDate
                    Definition

                    The date when the condition was first recorded in the referring facility's clinical record.


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

                    ShortDate condition was recordedDate record was first recorded
                    Control0..1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. 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()))
                    con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
                    44. 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())
                    46. 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 ConditionStagehttp://hl7.org/fhir/ValueSet/condition-stage|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/condition-stage|4.0.1)

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

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActorSource
                      SHALL:handlePH Core Serverfrom PH Core Condition
                      SHALL:handlePH Core Consumerfrom PH Core Condition
                      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. Condition.stage.summary.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Must Supporttrue
                      Obligations
                        ObligationsActorSource
                        SHALL:handlePH Core Serverfrom PH Core Condition
                        SHALL:handlePH Core Consumerfrom PH Core Condition
                        MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. Condition.stage.summary.text
                        Definition

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

                        Very often the text is the same as a displayName of one of the codings.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Obligations
                          ObligationsActorSource
                          SHALL:handlePH Core Serverfrom PH Core Condition
                          SHALL:handlePH Core Consumerfrom PH Core Condition
                          MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                          Summarytrue
                          Requirements

                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                          ShortKind of staging
                          Control0..1
                          BindingFor example codes, see ConditionStageTypehttp://hl7.org/fhir/ValueSet/condition-stage-type|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/condition-stage-type|4.0.1)

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

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActorSource
                            SHALL:handlePH Core Serverfrom PH Core Condition
                            SHALL:handlePH Core Consumerfrom PH Core Condition
                            MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            54. Condition.stage.type.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                            Control0..*
                            TypeCoding
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActorSource
                              SHALL:handlePH Core Serverfrom PH Core Condition
                              SHALL:handlePH Core Consumerfrom PH Core Condition
                              MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              56. Condition.stage.type.text
                              Definition

                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                              ShortPlain text representation of the concept
                              Comments

                              Very often the text is the same as a displayName of one of the codings.

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Obligations
                                ObligationsActorSource
                                SHALL:handlePH Core Serverfrom PH Core Condition
                                SHALL:handlePH Core Consumerfrom PH Core Condition
                                MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                Summarytrue
                                Requirements

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                58. 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()))
                                con-2: evidence SHALL have code or details (code.exists() or detail.exists())
                                60. 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())
                                62. 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 ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptom|4.0.1
                                (example to http://hl7.org/fhir/ValueSet/manifestation-or-symptom|4.0.1)

                                Codes that describe the manifestation or symptoms of a condition.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActorSource
                                  SHALL:handlePH Core Serverfrom PH Core Condition
                                  SHALL:handlePH Core Consumerfrom PH Core Condition
                                  MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  64. Condition.evidence.code.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..*
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActorSource
                                    SHALL:handlePH Core Serverfrom PH Core Condition
                                    SHALL:handlePH Core Consumerfrom PH Core Condition
                                    MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    66. Condition.evidence.code.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActorSource
                                      SHALL:handlePH Core Serverfrom PH Core Condition
                                      SHALL:handlePH Core Consumerfrom PH Core Condition
                                      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                      Summarytrue
                                      Requirements

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                      Additional clinical notes about the condition that may support referral assessment or triage.


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

                                      ShortCondition notesAdditional information about the Condition
                                      Control0..*
                                      TypeAnnotation
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      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
                                      2. Condition.clinicalStatus
                                      Definition

                                      The current clinical status of the diagnosis, problem, or condition relevant to the referral.

                                      ShortClinical status of the condition
                                      4. Condition.verificationStatus
                                      Definition

                                      The certainty or verification state for the diagnosis, problem, or condition, such as provisional or confirmed.

                                      ShortVerification status of the condition
                                      6. Condition.category
                                      Definition

                                      Categorizes the condition as a problem list item, encounter diagnosis, or other category supported by the inherited PH Core binding.

                                      ShortCondition category
                                      8. Condition.code
                                      Definition

                                      The coded diagnosis, problem, symptom, or clinical condition that is relevant to the eReferral request.

                                      ShortDiagnosis, problem, or condition
                                      10. Condition.subject
                                      Definition

                                      The patient who has the diagnosis, problem, or clinical condition relevant to the referral.

                                      ShortPatient with the condition
                                      12. Condition.onset[x]
                                      Definition

                                      The estimated or known date, date/time, age, period, range, or text describing when the condition began.

                                      ShortCondition onset
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Must Supporttrue
                                      14. Condition.recordedDate
                                      Definition

                                      The date when the condition was first recorded in the referring facility's clinical record.

                                      ShortDate condition was recorded
                                      Must Supporttrue
                                      16. Condition.note
                                      Definition

                                      Additional clinical notes about the condition that may support referral assessment or triage.

                                      ShortCondition notes

                                      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.

                                      ShortDetailed 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())
                                      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|4.0.1)

                                      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 current clinical status of the diagnosis, problem, or condition relevant to the referral.

                                      ShortClinical status of the condition
                                      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
                                      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
                                        ObligationsActorSource
                                        SHALL:handlePH Core Serverfrom PH Core Condition
                                        SHALL:handlePH Core Consumerfrom PH Core Condition
                                        MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        22. Condition.clinicalStatus.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
                                        24. Condition.clinicalStatus.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.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 26. Condition.clinicalStatus.coding
                                          Definition

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                          Control0..*
                                          TypeCoding
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActorSource
                                            SHALL:handlePH Core Serverfrom PH Core Condition
                                            SHALL:handlePH Core Consumerfrom PH Core Condition
                                            MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                            Summarytrue
                                            Requirements

                                            Allows for alternative encodings within a code system, and translations to other code systems.

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

                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                            ShortPlain text representation of the concept
                                            Comments

                                            Very often the text is the same as a displayName of one of the codings.

                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActorSource
                                              SHALL:handlePH Core Serverfrom PH Core Condition
                                              SHALL:handlePH Core Consumerfrom PH Core Condition
                                              MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                              Summarytrue
                                              Requirements

                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                              The certainty or verification state for the diagnosis, problem, or condition, such as provisional or confirmed.

                                              ShortVerification status of the condition
                                              Comments

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

                                              Control0..1
                                              This element is affected by the following invariants: con-3, con-5
                                              BindingThe codes SHALL be taken from 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
                                              Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActorSource
                                                SHALL:handlePH Core Serverfrom PH Core Condition
                                                SHALL:handlePH Core Consumerfrom PH Core Condition
                                                MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                32. Condition.verificationStatus.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
                                                34. Condition.verificationStatus.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.verificationStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 36. Condition.verificationStatus.coding
                                                  Definition

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                  Control0..*
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActorSource
                                                    SHALL:handlePH Core Serverfrom PH Core Condition
                                                    SHALL:handlePH Core Consumerfrom PH Core Condition
                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                    Summarytrue
                                                    Requirements

                                                    Allows for alternative encodings within a code system, and translations to other code systems.

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

                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                    ShortPlain text representation of the concept
                                                    Comments

                                                    Very often the text is the same as a displayName of one of the codings.

                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActorSource
                                                      SHALL:handlePH Core Serverfrom PH Core Condition
                                                      SHALL:handlePH Core Consumerfrom PH Core Condition
                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                      Summarytrue
                                                      Requirements

                                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                                      Categorizes the condition as a problem list item, encounter diagnosis, or other category supported by the inherited PH Core binding.

                                                      ShortCondition category
                                                      Comments

                                                      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 ConditionCategoryCodes
                                                      (extensible to http://hl7.org/fhir/ValueSet/condition-category|4.0.1)

                                                      A category assigned to the condition.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      42. 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|4.0.1)

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

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

                                                      The coded diagnosis, problem, symptom, or clinical condition that is relevant to the eReferral request.

                                                      ShortDiagnosis, problem, or condition
                                                      Control0..1
                                                      BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                                      (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                                      Identification of the condition or diagnosis.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      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()))
                                                      46. Condition.code.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
                                                      48. Condition.code.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.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 50. Condition.code.coding
                                                        Definition

                                                        A reference to a code defined by a terminology system.

                                                        ShortCode defined by a terminology system
                                                        Comments

                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                        Control0..*
                                                        TypeCoding
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Allows for alternative encodings within a code system, and translations to other code systems.

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

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortPlain text representation of the concept
                                                        Comments

                                                        Very often the text is the same as a displayName of one of the codings.

                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        54. 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..*
                                                        BindingFor example codes, see SNOMEDCTBodyStructures
                                                        (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

                                                        Codes describing anatomical locations. May include laterality.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActorSource
                                                          SHALL:handlePH Core Serverfrom PH Core Condition
                                                          SHALL:handlePH Core Consumerfrom PH Core Condition
                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          56. Condition.bodySite.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
                                                          58. Condition.bodySite.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.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 60. Condition.bodySite.coding
                                                            Definition

                                                            A reference to a code defined by a terminology system.

                                                            ShortCode defined by a terminology system
                                                            Comments

                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                            Control0..*
                                                            TypeCoding
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActorSource
                                                              SHALL:handlePH Core Serverfrom PH Core Condition
                                                              SHALL:handlePH Core Consumerfrom PH Core Condition
                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                              Summarytrue
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

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

                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                              ShortPlain text representation of the concept
                                                              Comments

                                                              Very often the text is the same as a displayName of one of the codings.

                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActorSource
                                                                SHALL:handlePH Core Serverfrom PH Core Condition
                                                                SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                Summarytrue
                                                                Requirements

                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                                                The patient who has the diagnosis, problem, or clinical condition relevant to the referral.

                                                                ShortPatient with the condition
                                                                Control1..1
                                                                TypeReference(PH Core Patient)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Requirements

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

                                                                Alternate Namespatient
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                66. 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(PH Core Encounter)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                68. Condition.onset[x]
                                                                Definition

                                                                The estimated or known date, date/time, age, period, range, or text describing when the condition began.

                                                                ShortCondition onset
                                                                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
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                70. 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()))
                                                                72. Condition.recordedDate
                                                                Definition

                                                                The date when the condition was first recorded in the referring facility's clinical record.

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

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

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

                                                                Individual who is making the condition statement.

                                                                ShortPerson who asserts this condition
                                                                Control0..1
                                                                TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Patient, PH Core RelatedPerson)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                78. 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()))
                                                                80. 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
                                                                82. 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())
                                                                84. 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())
                                                                86. 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|4.0.1)

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActorSource
                                                                  SHALL:handlePH Core Serverfrom PH Core Condition
                                                                  SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  88. Condition.stage.summary.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
                                                                  90. Condition.stage.summary.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.stage.summary.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 92. Condition.stage.summary.coding
                                                                    Definition

                                                                    A reference to a code defined by a terminology system.

                                                                    ShortCode defined by a terminology system
                                                                    Comments

                                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                    Control0..*
                                                                    TypeCoding
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActorSource
                                                                      SHALL:handlePH Core Serverfrom PH Core Condition
                                                                      SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      94. Condition.stage.summary.text
                                                                      Definition

                                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                      ShortPlain text representation of the concept
                                                                      Comments

                                                                      Very often the text is the same as a displayName of one of the codings.

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActorSource
                                                                        SHALL:handlePH Core Serverfrom PH Core Condition
                                                                        SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                        MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                        Summarytrue
                                                                        Requirements

                                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        96. 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()))
                                                                        98. 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|4.0.1)

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

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActorSource
                                                                          SHALL:handlePH Core Serverfrom PH Core Condition
                                                                          SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          100. Condition.stage.type.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
                                                                          102. Condition.stage.type.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.stage.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 104. Condition.stage.type.coding
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode defined by a terminology system
                                                                            Comments

                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                            Control0..*
                                                                            TypeCoding
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActorSource
                                                                              SHALL:handlePH Core Serverfrom PH Core Condition
                                                                              SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                              Summarytrue
                                                                              Requirements

                                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              106. Condition.stage.type.text
                                                                              Definition

                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                              ShortPlain text representation of the concept
                                                                              Comments

                                                                              Very often the text is the same as a displayName of one of the codings.

                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActorSource
                                                                                SHALL:handlePH Core Serverfrom PH Core Condition
                                                                                SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                                MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                                Summarytrue
                                                                                Requirements

                                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                108. 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()))
                                                                                110. 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
                                                                                112. 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())
                                                                                114. 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())
                                                                                116. 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|4.0.1)

                                                                                Codes that describe the manifestation or symptoms of a condition.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActorSource
                                                                                  SHALL:handlePH Core Serverfrom PH Core Condition
                                                                                  SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  118. Condition.evidence.code.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
                                                                                  120. Condition.evidence.code.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.evidence.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 122. Condition.evidence.code.coding
                                                                                    Definition

                                                                                    A reference to a code defined by a terminology system.

                                                                                    ShortCode defined by a terminology system
                                                                                    Comments

                                                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                    Control0..*
                                                                                    TypeCoding
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActorSource
                                                                                      SHALL:handlePH Core Serverfrom PH Core Condition
                                                                                      SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      124. Condition.evidence.code.text
                                                                                      Definition

                                                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                      ShortPlain text representation of the concept
                                                                                      Comments

                                                                                      Very often the text is the same as a displayName of one of the codings.

                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActorSource
                                                                                        SHALL:handlePH Core Serverfrom PH Core Condition
                                                                                        SHALL:handlePH Core Consumerfrom PH Core Condition
                                                                                        MAY:able-to-populatePH Core Creatorfrom PH Core Condition
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        126. 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()))
                                                                                        128. Condition.note
                                                                                        Definition

                                                                                        Additional clinical notes about the condition that may support referral assessment or triage.

                                                                                        ShortCondition notes
                                                                                        Control0..*
                                                                                        TypeAnnotation
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))