New Zealand Rheumatic Fever FHIR Implementation Guide
1.0.0 - draft
New Zealand Rheumatic Fever FHIR Implementation Guide, published by Te Whatu Ora. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/fhir-rheumatic-fever/ and changes regularly. See the Directory of published versions
Draft as of 2024-09-26 |
Definitions for the nz-rheumaticfever-condition resource profile.
Guidance on how to interpret the contents of this table can be found here
0. Condition | |
Invariants | RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) (Condition.category.where(coding.code='rf-nz').exists() )RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)' ( Condition.category.where(coding.code='58718002').exists() ) |
2. Condition.meta | |
Invariants | RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) (tag.code contains 'rf-nz' ) |
4. Condition.implicitRules | |
Control | 0..0 |
6. Condition.language | |
Control | 0..0 |
8. Condition.extension:rhdSeverity | |
Slice Name | rhdSeverity |
Control | 0..1 |
Type | Extension(Severity of rheumatic heart disease) (Extension Type: Coding) |
10. Condition.extension:diagnosticCertainty | |
Slice Name | diagnosticCertainty |
Short | **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element** |
Control | 0..1 |
Type | Extension(Certainty of rheumatic fever diagnosis) (Extension Type: Coding) |
12. Condition.extension:assessmentDate | |
Slice Name | assessmentDate |
Short | date (dateTime value in UTC timezone) of RHD severity assessment |
Control | 0..1 |
Type | Extension(Date of assessment of rheumatic heart disease severity) (Extension Type: dateTime) |
14. Condition.extension:symptomStatusAtDiagnosis | |
Slice Name | symptomStatusAtDiagnosis |
Control | 0..1 |
Type | Extension(Symptom status at diagnosis) (Extension Type: Coding) |
16. Condition.identifier | |
Note | This is a business identifier, not a resource identifier (see discussion) |
Slicing | This element introduces a set of slices on Condition.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
18. Condition.identifier:NationalSystem | |
Slice Name | NationalSystem |
Short | This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
20. Condition.identifier:NationalSystem.id | |
Control | 0..0 |
22. Condition.identifier:NationalSystem.extension | |
Control | 0..0 |
24. Condition.identifier:NationalSystem.use | |
Control | 1..? |
Pattern Value | usual |
26. Condition.identifier:NationalSystem.type | |
Control | 1..? |
Binding | The codes SHALL be taken from External identifier type codes (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code ) |
28. Condition.identifier:NationalSystem.system | |
Example | <br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs |
30. Condition.identifier:NationalSystem.value | |
Control | 1..? |
Example | <br/><b>RFCCS object id</b>:CON-0206 |
32. Condition.category | |
Control | 1..? |
34. Condition.code | |
Short | Must be one of the diagnosis codes |
Control | 1..? |
Binding | The codes SHALL be taken from Codes for summary diagnosis of the rheumatic fever condition (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code ) |
36. Condition.subject | |
Short | Must be a reference to Patient instance using the rheumatic fever profile |
Type | Reference(Rheumatic Fever Patient) |
38. Condition.onset[x] | |
Short | The date (UTC dateTime) when rheumatic fever was thought to have begun |
Type | dateTime, string, Period, Range, Age |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. Condition.recordedDate | |
Short | The date (UTC dateTime) of diagnosis |
42. Condition.recorder | |
Type | Reference(Practitioner) |
44. Condition.stage | |
Control | 0..0 |
46. Condition.evidence | |
Control | 0..3 |
48. Condition.evidence.extension | |
Control | 0..0 |
50. Condition.evidence.modifierExtension | |
Control | 0..0 |
52. Condition.evidence.code | |
Short | Identifies the GROUPing of diagnosis data in the linked Observation instance |
Binding | The codes SHOULD be taken from Codes for rheumatic fever diagnosis observation grouping (preferred to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code ) |
54. Condition.evidence.detail | |
Short | Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail |
Type | Reference(Rheumatic Fever Diagnosis Group) |
Guidance on how to interpret the contents of this table can be found here
0. Condition | |||||
Definition | A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern. | ||||
Short | Detailed information about conditions, problems or diagnoses | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | 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() )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()) RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) ( Condition.category.where(coding.code='rf-nz').exists() )RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)' ( Condition.category.where(coding.code='58718002').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.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. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) ( tag.code contains 'rf-nz' ) | ||||
4. 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. | ||||
Short | A 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. | ||||
Control | 0..01 | ||||
Type | uri | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
6. Condition.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language 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). | ||||
Control | 0..01 | ||||
Binding | The codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
8. Condition.extension:long-term-condition | |||||
Slice Name | long-term-condition | ||||
Definition | Long Term Condition Indicator. A long term condition can be defined as any ongoing, long term or recurring conditions that can have a significant impact on people’s lives. | ||||
Short | Long Term Condition Indicator | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Long Term Condition Indicator) (Extension Type: boolean) | ||||
Is Modifier | false | ||||
Invariants | ele-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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
10. Condition.extension:rhdSeverity | |||||
Slice Name | rhdSeverity | ||||
Definition | Severity of rheumatic heart disease determines the severity of a patient's rheumatic fever condition. | ||||
Short | Severity of rheumatic heart disease | ||||
Control | 0..1 | ||||
Type | Extension(Severity of rheumatic heart disease) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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()) | ||||
12. Condition.extension:diagnosticCertainty | |||||
Slice Name | diagnosticCertainty | ||||
Definition | Certainty of rheumatic fever diagnosis | ||||
Short | **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element** | ||||
Control | 0..1 | ||||
Type | Extension(Certainty of rheumatic fever diagnosis) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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()) | ||||
14. Condition.extension:assessmentDate | |||||
Slice Name | assessmentDate | ||||
Definition | Tracks the RF-specific date when rheumatic heart disease severity was assessed. | ||||
Short | date (dateTime value in UTC timezone) of RHD severity assessment | ||||
Control | 0..1 | ||||
Type | Extension(Date of assessment of rheumatic heart disease severity) (Extension Type: dateTime) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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.extension:symptomStatusAtDiagnosis | |||||
Slice Name | symptomStatusAtDiagnosis | ||||
Definition | Symptom status at time of rheumatic fever diagnosis | ||||
Short | Symptom status at diagnosis | ||||
Control | 0..1 | ||||
Type | Extension(Symptom status at diagnosis) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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.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). | ||||
Short | Extensions 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
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 Names | extensions, user content | ||||
Invariants | ele-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()) | ||||
20. 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. | ||||
Short | External 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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
Slicing | This element introduces a set of slices on Condition.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
22. Condition.identifier:NationalSystem | |||||
Slice Name | NationalSystem | ||||
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. | ||||
Short | This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.External 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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
24. Condition.identifier:NationalSystem.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..01 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
26. Condition.identifier:NationalSystem.extension | |||||
Definition | An Extension 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. | ||||
Short | ExtensionAdditional 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. | ||||
Control | 0..0* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-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()) | ||||
Slicing | This element introduces a set of slices on Condition.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
28. Condition.identifier:NationalSystem.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 10..1 | ||||
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Pattern Value | usual | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
30. Condition.identifier:NationalSystem.type | |||||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | Description of identifier | ||||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
Control | 10..1 | ||||
Binding | The codes SHALL be taken from Unless not suitable, these codes SHALL be taken from External identifier type codeshttp://hl7.org/fhir/ValueSet/identifier-type (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
32. Condition.identifier:NationalSystem.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient <br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
34. Condition.identifier:NationalSystem.value | |||||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
Short | The value that is unique | ||||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. | ||||
Control | 10..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:123456 <br/><b>RFCCS object id</b>:CON-0206 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
36. Condition.clinicalStatus | |||||
Definition | The clinical status of the condition. | ||||
Short | active | 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. | ||||
Control | 0..1 This element is affected by the following invariants: con-3, con-4, con-5 | ||||
Binding | The 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. | ||||
Type | CodeableConcept | ||||
Is Modifier | true because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active. | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
38. Condition.verificationStatus | |||||
Definition | The verification status to support the clinical status of the condition. | ||||
Short | unconfirmed | 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. | ||||
Control | 0..1 This element is affected by the following invariants: con-3, con-5 | ||||
Binding | The 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. | ||||
Type | CodeableConcept | ||||
Is Modifier | true 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. | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
40. Condition.category | |||||
Definition | A category assigned to the condition. | ||||
Short | problem-list-item | encounter-diagnosis | ||||
Comments | The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts. | ||||
Control | 10..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-category (extensible to http://hl7.org/fhir/ValueSet/condition-category )A category assigned to the condition. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
42. Condition.code | |||||
Definition | Identification of the condition, problem or diagnosis. | ||||
Short | Must be one of the diagnosis codesIdentification of the condition, problem or diagnosis | ||||
Control | 10..1 | ||||
Binding | The codes SHALL be taken from For example codes, see Codes for summary diagnosis of the rheumatic fever conditionhttp://hl7.org/fhir/ValueSet/condition-code (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | 0..1 to account for primarily narrative only resources. | ||||
Alternate Names | type | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
44. Condition.subject | |||||
Definition | Indicates the patient or group who the condition record is associated with. | ||||
Short | Must be a reference to Patient instance using the rheumatic fever profileWho has the condition? | ||||
Control | 1..1 | ||||
Type | Reference(Rheumatic Fever Patient, Patient, Group) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Group is typically used for veterinary or public health use cases. | ||||
Alternate Names | patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
46. Condition.onset[x] | |||||
Definition | Estimated or actual date or date-time the condition began, in the opinion of the clinician. | ||||
Short | The date (UTC dateTime) when rheumatic fever was thought to have begunEstimated 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. | ||||
Control | 0..1 | ||||
Type | dateTime, string, Period, Range, Age | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
48. Condition.recordedDate | |||||
Definition | The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date. | ||||
Short | The date (UTC dateTime) of diagnosisDate record was first recorded | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
50. Condition.recorder | |||||
Definition | Individual who recorded the record and takes responsibility for its content. | ||||
Short | Who recorded the condition | ||||
Control | 0..1 | ||||
Type | Reference(Practitioner, PractitionerRole, Patient, RelatedPerson) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
52. Condition.stage | |||||
Definition | Clinical stage or grade of a condition. May include formal severity assessments. | ||||
Short | Stage/grade, usually assessed formally | ||||
Control | 0..0* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | con-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()) | ||||
55. 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. | ||||
Short | Supporting evidence | ||||
Comments | The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both. | ||||
Control | 0..3* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | con-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()) | ||||
57. Condition.evidence.extension | |||||
Definition | An Extension 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. | ||||
Short | ExtensionAdditional 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. | ||||
Control | 0..0* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-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()) | ||||
59. Condition.evidence.modifierExtension | |||||
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | ExtensionExtensions 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. | ||||
Control | 0..0* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
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 Names | extensions, user content, modifiers | ||||
Invariants | ele-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()) | ||||
61. Condition.evidence.code | |||||
Definition | A manifestation or symptom that led to the recording of this condition. | ||||
Short | Identifies the GROUPing of diagnosis data in the linked Observation instanceManifestation/symptom | ||||
Control | 0..* This element is affected by the following invariants: con-2 | ||||
Binding | The codes SHOULD be taken from For example codes, see Codes for rheumatic fever diagnosis observation groupinghttp://hl7.org/fhir/ValueSet/manifestation-or-symptom (preferred to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
63. Condition.evidence.detail | |||||
Definition | Links to other relevant information, including pathology reports. | ||||
Short | Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detailSupporting information found elsewhere | ||||
Control | 0..* This element is affected by the following invariants: con-2 | ||||
Type | Reference(Rheumatic Fever Diagnosis Group, Resource) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. Condition | |||||
Definition | A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern. | ||||
Short | Detailed information about conditions, problems or diagnoses | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | 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() )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() )RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) ( Condition.category.where(coding.code='rf-nz').exists() )RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)' ( Condition.category.where(coding.code='58718002').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. | ||||
Short | Logical 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. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Summary | true | ||||
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. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) ( tag.code contains 'rf-nz' ) | ||||
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. | ||||
Short | A 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. | ||||
Control | 0..0 | ||||
Type | uri | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-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. | ||||
Short | Language 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). | ||||
Control | 0..0 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-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. | ||||
Short | Text 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. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-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. | ||||
Short | Contained, 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. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. Condition.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
Slicing | This element introduces a set of slices on Condition.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
16. Condition.extension:long-term-condition | |||||
Slice Name | long-term-condition | ||||
Definition | Long Term Condition Indicator. A long term condition can be defined as any ongoing, long term or recurring conditions that can have a significant impact on people’s lives. | ||||
Short | Long Term Condition Indicator | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Long Term Condition Indicator) (Extension Type: boolean) | ||||
Is Modifier | false | ||||
Invariants | ele-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.extension:rhdSeverity | |||||
Slice Name | rhdSeverity | ||||
Definition | Severity of rheumatic heart disease determines the severity of a patient's rheumatic fever condition. | ||||
Short | Severity of rheumatic heart disease | ||||
Control | 0..1 | ||||
Type | Extension(Severity of rheumatic heart disease) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
20. Condition.extension:diagnosticCertainty | |||||
Slice Name | diagnosticCertainty | ||||
Definition | Certainty of rheumatic fever diagnosis | ||||
Short | **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element** | ||||
Control | 0..1 | ||||
Type | Extension(Certainty of rheumatic fever diagnosis) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
22. Condition.extension:assessmentDate | |||||
Slice Name | assessmentDate | ||||
Definition | Tracks the RF-specific date when rheumatic heart disease severity was assessed. | ||||
Short | date (dateTime value in UTC timezone) of RHD severity assessment | ||||
Control | 0..1 | ||||
Type | Extension(Date of assessment of rheumatic heart disease severity) (Extension Type: dateTime) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
24. Condition.extension:symptomStatusAtDiagnosis | |||||
Slice Name | symptomStatusAtDiagnosis | ||||
Definition | Symptom status at time of rheumatic fever diagnosis | ||||
Short | Symptom status at diagnosis | ||||
Control | 0..1 | ||||
Type | Extension(Symptom status at diagnosis) (Extension Type: Coding) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
26. 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). | ||||
Short | Extensions 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
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 Names | extensions, user content | ||||
Invariants | ele-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() ) | ||||
28. 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. | ||||
Short | External 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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Condition.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
30. Condition.identifier:NationalSystem | |||||
Slice Name | NationalSystem | ||||
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. | ||||
Short | This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR. | ||||
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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
32. Condition.identifier:NationalSystem.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..0 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
34. Condition.identifier:NationalSystem.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..0 | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
Slicing | This element introduces a set of slices on Condition.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
36. Condition.identifier:NationalSystem.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Pattern Value | usual | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
38. Condition.identifier:NationalSystem.type | |||||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | Description of identifier | ||||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from External identifier type codes (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. Condition.identifier:NationalSystem.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient <br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. Condition.identifier:NationalSystem.value | |||||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
Short | The value that is unique | ||||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. | ||||
Control | 1..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:123456 <br/><b>RFCCS object id</b>:CON-0206 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. Condition.identifier:NationalSystem.period | |||||
Definition | Time period during which identifier is/was valid for use. | ||||
Short | Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
46. Condition.identifier:NationalSystem.assigner | |||||
Definition | Organization that issued/manages the identifier. | ||||
Short | Organization that issued id (may be just text) | ||||
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||||
Control | 0..1 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
48. Condition.clinicalStatus | |||||
Definition | The clinical status of the condition. | ||||
Short | active | 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. | ||||
Control | 0..1 This element is affected by the following invariants: con-3, con-4, con-5 | ||||
Binding | The 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. | ||||
Type | CodeableConcept | ||||
Is Modifier | true because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active. | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
50. Condition.verificationStatus | |||||
Definition | The verification status to support the clinical status of the condition. | ||||
Short | unconfirmed | 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. | ||||
Control | 0..1 This element is affected by the following invariants: con-3, con-5 | ||||
Binding | The 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. | ||||
Type | CodeableConcept | ||||
Is Modifier | true 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. | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
52. Condition.category | |||||
Definition | A category assigned to the condition. | ||||
Short | problem-list-item | encounter-diagnosis | ||||
Comments | The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts. | ||||
Control | 1..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from ConditionCategoryCodes (extensible to http://hl7.org/fhir/ValueSet/condition-category )A category assigned to the condition. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
54. Condition.severity | |||||
Definition | A subjective assessment of the severity of the condition as evaluated by the clinician. | ||||
Short | Subjective severity of condition | ||||
Comments | Coding of the severity with a terminology is preferred, where possible. | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from Condition/DiagnosisSeverity (preferred to http://hl7.org/fhir/ValueSet/condition-severity )A subjective assessment of the severity of the condition as evaluated by the clinician. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
56. Condition.code | |||||
Definition | Identification of the condition, problem or diagnosis. | ||||
Short | Must be one of the diagnosis codes | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from Codes for summary diagnosis of the rheumatic fever condition (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | 0..1 to account for primarily narrative only resources. | ||||
Alternate Names | type | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
58. Condition.bodySite | |||||
Definition | The anatomical location where this condition manifests itself. | ||||
Short | Anatomical 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. | ||||
Control | 0..* | ||||
Binding | For example codes, see SNOMEDCTBodyStructures (example to http://hl7.org/fhir/ValueSet/body-site )Codes describing anatomical locations. May include laterality. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. Condition.subject | |||||
Definition | Indicates the patient or group who the condition record is associated with. | ||||
Short | Must be a reference to Patient instance using the rheumatic fever profile | ||||
Control | 1..1 | ||||
Type | Reference(Rheumatic Fever Patient) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Group is typically used for veterinary or public health use cases. | ||||
Alternate Names | patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. Condition.encounter | |||||
Definition | The Encounter during which this Condition was created or to which the creation of this record is tightly associated. | ||||
Short | Encounter 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". | ||||
Control | 0..1 | ||||
Type | Reference(Encounter) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. Condition.onset[x] | |||||
Definition | Estimated or actual date or date-time the condition began, in the opinion of the clinician. | ||||
Short | The date (UTC dateTime) when rheumatic fever was thought to have begun | ||||
Comments | Age is generally used when the patient reports an age at which the Condition began to occur. | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. 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. | ||||
Short | When 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. | ||||
Control | 0..1 This element is affected by the following invariants: con-4 | ||||
Type | Choice of: dateTime, Age, Period, Range, string | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. Condition.recordedDate | |||||
Definition | The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date. | ||||
Short | The date (UTC dateTime) of diagnosis | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. Condition.recorder | |||||
Definition | Individual who recorded the record and takes responsibility for its content. | ||||
Short | Who recorded the condition | ||||
Control | 0..1 | ||||
Type | Reference(Practitioner) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. Condition.asserter | |||||
Definition | Individual who is making the condition statement. | ||||
Short | Person who asserts this condition | ||||
Control | 0..1 | ||||
Type | Reference(Practitioner, PractitionerRole, Patient, RelatedPerson) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
74. Condition.stage | |||||
Definition | Clinical stage or grade of a condition. May include formal severity assessments. | ||||
Short | Stage/grade, usually assessed formally | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | con-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()) ) | ||||
82. 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. | ||||
Short | Supporting evidence | ||||
Comments | The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both. | ||||
Control | 0..3 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | con-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()) ) | ||||
84. 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. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
86. Condition.evidence.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..0 | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-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() ) | ||||
88. Condition.evidence.modifierExtension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..0 | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Invariants | ele-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() ) | ||||
90. Condition.evidence.code | |||||
Definition | A manifestation or symptom that led to the recording of this condition. | ||||
Short | Identifies the GROUPing of diagnosis data in the linked Observation instance | ||||
Control | 0..* This element is affected by the following invariants: con-2 | ||||
Binding | The codes SHOULD be taken from Codes for rheumatic fever diagnosis observation grouping (preferred to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
92. Condition.evidence.detail | |||||
Definition | Links to other relevant information, including pathology reports. | ||||
Short | Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail | ||||
Control | 0..* This element is affected by the following invariants: con-2 | ||||
Type | Reference(Rheumatic Fever Diagnosis Group) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
94. Condition.note | |||||
Definition | Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis. | ||||
Short | Additional information about the Condition | ||||
Control | 0..* | ||||
Type | Annotation | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |