Name Flags Card. Type Description & Constraints doco
. . Condition Σ DomainResource Detailed information about conditions, problems or diagnoses
. . . identifier Σ 0..* Identifier External Ids for this condition
. . . patient Σ 1..1 Reference( Patient) Who has the condition?
. . . encounter Σ 0..1 Reference( Encounter) Encounter when condition first asserted
. . . asserter Σ 0..1 Reference( Practitioner | Patient) Person who asserts this condition
. . . dateRecorded Σ 0..1 date When first entered
. . . code Σ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Condition/Problem/Diagnosis Codes ( Example)
. . . category Σ 0..1 CodeableConcept complaint | symptom | finding | diagnosis
Condition Category Codes ( Preferred)
. . . clinicalStatus ?! Σ 0..1 code active | relapse | remission | resolved
Condition Clinical Status Codes ( Preferred)
. . . verificationStatus ?! Σ 1..1 code provisional | differential | confirmed | refuted | entered-in-error | unknown
ConditionVerificationStatus ( Required)
. . . severity Σ 0..1 CodeableConcept Subjective severity of condition
Condition/Diagnosis Severity ( Preferred)
. . . onset[x] Σ 0..1 Estimated or actual date, date-time, or age
. . . . onsetDateTime dateTime
. . . . onsetQuantity Age
. . . . onsetPeriod Period
. . . . onsetRange Range
. . . . onsetString string
. . . abatement[x] Σ 0..1 If/when in resolution/remission
. . . . abatementDateTime dateTime
. . . . abatementQuantity Age
. . . . abatementBoolean boolean
. . . . abatementPeriod Period
. . . . abatementRange Range
. . . . abatementString string
. . . stage Σ I 0..1 BackboneElement Stage/grade, usually assessed formally
Stage SHALL have summary or assessment
. . . . summary Σ I 0..1 CodeableConcept Simple summary (disease specific)
Condition Stage ( Example)
. . . . assessment Σ I 0..* Reference( ClinicalImpression | DiagnosticReport | Observation) Formal record of assessment
. . . evidence Σ I 0..* BackboneElement Supporting evidence
evidence SHALL have code or details
. . . . code Σ I 0..1 CodeableConcept Manifestation/symptom
Manifestation and Symptom Codes ( Example)
. . . . detail Σ I 0..* Reference( Any) Supporting information found elsewhere
. . . bodySite Σ 0..* CodeableConcept Anatomical location, if relevant
SNOMED CT Body Structures ( Example)
. . . notes Σ 0..1 string Additional information about the Condition

doco Documentation for this format