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

Resource Profile: Rheumatic Fever Condition

Official URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/nz-rheumaticfever-condition Version: 1.0.0
Draft as of 2024-09-26 Computable Name: RheumaticFeverCondition

Extends NzCondition to add classifiers for RHD severity, diagnostic certainty and symptomatic status and specifies groups of diagnosic evidence that can be attached.

Adds classifiers for severity, diagnostic certainty and symptomatic status and specifies groups of diagnosic evidence to be attached

Usage:

Formal Views of Profile Content

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

This structure is derived from NzCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... meta C 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules 0..0
... language 0..0
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... Slices for identifier 0..* Identifier External Ids for this condition
Slice: Unordered, Open by value:use
.... identifier:NationalSystem 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... id 0..0
..... extension 0..0
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... type 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system 0..1 uri The namespace for the identifier value
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value 1..1 string The value that is unique
Example RFCCS object id: CON-0206
... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
... code 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... subject 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... onset[x] 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... recordedDate 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder 0..1 Reference(Practitioner) Who recorded the condition
... stage 0..0
... evidence 0..3 BackboneElement Supporting evidence
.... extension 0..0
.... modifierExtension 0..0
.... code 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... Slices for extension Content/Rules for all slices
.... long-term-condition 0..1 boolean Long Term Condition Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/long-term-condition
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... identifier:NationalSystem Σ 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... extension 0..0
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value Σ 1..1 string The value that is unique
Example General: 123456
Example RFCCS object id: CON-0206
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... code Σ 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... subject Σ 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... onset[x] Σ 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... recordedDate Σ 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder Σ 0..1 Reference(Practitioner) Who recorded the condition
... evidence C 0..3 BackboneElement Supporting evidence
con-2: evidence SHALL have code or details
.... code ΣC 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail ΣC 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Condition.identifier:NationalSystem.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... id Σ 0..1 id Logical id of this artifact
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... text 0..1 Narrative Text summary of the resource, for human interpretation
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... long-term-condition 0..1 boolean Long Term Condition Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/long-term-condition
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier External Ids for this condition
Slice: Unordered, Open by value:use
.... identifier:NationalSystem Σ 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... extension 0..0
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value Σ 1..1 string The value that is unique
Example General: 123456
Example RFCCS object id: CON-0206
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code Σ 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... subject Σ 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... onset[x] Σ 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... abatement[x] C 0..1 When in resolution/remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder Σ 0..1 Reference(Practitioner) Who recorded the condition
... asserter Σ 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Person who asserts this condition
... evidence C 0..3 BackboneElement Supporting evidence
con-2: evidence SHALL have code or details
.... id 0..1 string Unique id for inter-element referencing
.... code ΣC 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail ΣC 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail
... note 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Condition.identifier:NationalSystem.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredCondition/DiagnosisSeverity
http://hl7.org/fhir/ValueSet/condition-severity
from the FHIR Standard
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

Differential View

This structure is derived from NzCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... meta C 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules 0..0
... language 0..0
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... Slices for identifier 0..* Identifier External Ids for this condition
Slice: Unordered, Open by value:use
.... identifier:NationalSystem 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... id 0..0
..... extension 0..0
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... type 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system 0..1 uri The namespace for the identifier value
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value 1..1 string The value that is unique
Example RFCCS object id: CON-0206
... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
... code 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... subject 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... onset[x] 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... recordedDate 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder 0..1 Reference(Practitioner) Who recorded the condition
... stage 0..0
... evidence 0..3 BackboneElement Supporting evidence
.... extension 0..0
.... modifierExtension 0..0
.... code 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... Slices for extension Content/Rules for all slices
.... long-term-condition 0..1 boolean Long Term Condition Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/long-term-condition
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... identifier:NationalSystem Σ 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... extension 0..0
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value Σ 1..1 string The value that is unique
Example General: 123456
Example RFCCS object id: CON-0206
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... code Σ 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... subject Σ 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... onset[x] Σ 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... recordedDate Σ 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder Σ 0..1 Reference(Practitioner) Who recorded the condition
... evidence C 0..3 BackboneElement Supporting evidence
con-2: evidence SHALL have code or details
.... code ΣC 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail ΣC 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Condition.identifier:NationalSystem.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* NzCondition Detailed information about conditions, problems or diagnoses
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
RFConditionNZCategoryConstraint: All RF Condition instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG)
RFConditionSNOMEDCategoryConstraint: All RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
... id Σ 0..1 id Logical id of this artifact
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... text 0..1 Narrative Text summary of the resource, for human interpretation
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... long-term-condition 0..1 boolean Long Term Condition Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/long-term-condition
.... rhdSeverity 0..1 Coding Severity of rheumatic heart disease
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-rhdseverity
Binding: Rheumatic heart disease severity codes (required)
.... diagnosticCertainty 0..1 Coding **This certainty code MUST be interpreted in conjunction with the patient's diagnosis in the .code element**
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-diagnosticcertainty
Binding: Rheumatic fever certainty of diagnosis codes (required)
.... assessmentDate 0..1 dateTime date (dateTime value in UTC timezone) of RHD severity assessment
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-assessmentdate
.... symptomStatusAtDiagnosis 0..1 Coding Symptom status at diagnosis
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-condition-symptomaticAtDiagnosis
Binding: Codes for rheumatic heart disease symptom status at time of diagnosis (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier External Ids for this condition
Slice: Unordered, Open by value:use
.... identifier:NationalSystem Σ 0..* Identifier This stores the identifier of the corresponding record in the national system (RFCCS) to let it be kept in sync with FHIR.
..... extension 0..0
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: External identifier type codes (required)
..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
Example uri: https://standards.digital.health.nz/ns/rfccs
..... value Σ 1..1 string The value that is unique
Example General: 123456
Example RFCCS object id: CON-0206
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code Σ 1..1 CodeableConcept Must be one of the diagnosis codes
Binding: Codes for summary diagnosis of the rheumatic fever condition (required)
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... subject Σ 1..1 Reference(Rheumatic Fever Patient) Must be a reference to Patient instance using the rheumatic fever profile
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... onset[x] Σ 0..1 dateTime The date (UTC dateTime) when rheumatic fever was thought to have begun
... abatement[x] C 0..1 When in resolution/remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime The date (UTC dateTime) of diagnosis
... recorder Σ 0..1 Reference(Practitioner) Who recorded the condition
... asserter Σ 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Person who asserts this condition
... evidence C 0..3 BackboneElement Supporting evidence
con-2: evidence SHALL have code or details
.... id 0..1 string Unique id for inter-element referencing
.... code ΣC 0..* CodeableConcept Identifies the GROUPing of diagnosis data in the linked Observation instance
Binding: Codes for rheumatic fever diagnosis observation grouping (preferred)
.... detail ΣC 0..* Reference(Rheumatic Fever Diagnosis Group) Links up to 3 Observation instances (all using the RF diagnosis group profile) to represent diagnosis detail
... note 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Condition.identifier:NationalSystem.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Condition.identifier:NationalSystem.typerequiredExternalSystemIdentifierTypeValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code
from this IG
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredCondition/DiagnosisSeverity
http://hl7.org/fhir/ValueSet/condition-severity
from the FHIR Standard
Condition.coderequiredRFConditionSummaryDiagnosisValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-condition-diagnosis-code
from this IG
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codepreferredRFDiagnosisGroupValueSet
https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-observation-diagnosisgroup-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
RFConditionNZCategoryConstrainterrorConditionAll 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()
RFConditionSNOMEDCategoryConstrainterrorConditionAll RF Condition instances shall have a category SNOMED #58718002 'Rheumatic fever (disorder)'
: Condition.category.where(coding.code='58718002').exists()
RFNZTagConstrainterrorCondition.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

 

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