<status value="active" /> <publisher value="Nictiz" /> <contact> <name value="Nictiz" /> <telecom> <system value="email" /> <value value="info@nictiz.nl" /> <use value="work" /> </telecom> </contact> <description value="Problem as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 4.1, release 2017. A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint), or by their healthcare provider (in the form of a diagnosis, for example). The situation can form cause for diagnostic or therapeutic policy. A problem includes all kinds of medical or nursing information that represents a health problem. A problem can represent various types of health problems: * A complaint, finding by patient: a subjective, negatively experienced observation of the patient’s health. Examples: stomach ache, amnesia. * A symptom: an observation by or about the patient which may indicate a certain disease. Examples: fever, blood in stool, white spots on the roof of the mouth; * A diagnosis: medical interpretation of complaints and findings. Examples: Diabetes Mellitus type II, pneumonia, hemolytic-uremic syndrome. * A functional limitation: a reduction of functional options. Examples: reduced mobility, help required for dressing. * A complication: Every diagnosis seen by the healthcare provider as an unforeseen and undesired result of medical action. Examples: post-operative wound infections, loss of hearing through the use of antibiotics." /> <purpose value="An overview of a patient’s health problems has the purpose of informing all healthcare providers involved in the patient’s care on the patient’s current and past health condition. It provides insight into which problems require medical action, which are under control and which are no longer current. The problem overview also directly provides medical context for medication administered and procedures carried out. The overview promotes an efficient, targeted continuation of the patient’s care. A complete list of problems is of importance for automated decision support and determining contraindications." /> <copyright value="CC0" /> <fhirVersion value="3.0.2" /> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <uri value="https://zibs.nl/wiki/ConcernForTransfer-v1.2(2015EN)" /> <name value="HCIM ConcernForTransfer-v1.2(2015EN)" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <uri value="https://zibs.nl/wiki/ConcernForTransfer-v3.0(2016EN)" /> <name value="HCIM ConcernForTransfer-v3.0(2016EN)" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <uri value="https://zibs.nl/wiki/Problem-v4.1(2017EN)" /> <name value="HCIM Problem-v4.1(2017EN)" /> <comment value="ConcernForTransfer is renamed to Problem with release 2017 of the HCIMs." /> </mapping> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <uri value="https://zibs.nl/wiki/BasicElements-v1.0(2017EN)" /> <name value="HCIM BasicElements-v1.0(2017EN)" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Condition" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Condition" /> <derivation value="constraint" /> <differential> <element id="Condition"> <path value="Condition" /> <short value="Problem" /> <definition value="A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint) or by their healthcare provider (in the form of a diagnosis, for example)." /> <alias value="Concern" /> <alias value="Probleem" /> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.1" /> <comment value="Concern" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.2" /> <comment value="Problem" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.1" /> <comment value="Concern" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.2" /> <comment value="Problem" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.1" /> <comment value="Problem" /> </mapping> </element> <element id="Condition.identifier"> <path value="Condition.identifier" /> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.6" /> <comment value="IdentificationNumber" /> </mapping> </element> <element id="Condition.clinicalStatus"> <path value="Condition.clinicalStatus" /> <short value="ProblemStatus" /> <definition value="The problem status describes the condition of the problem: <ol> <li>Active problems are problems of which the patient experiences symptoms or for which evidence exists.</li> <li>Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..</li> </ol>" /> <alias value="ProbleemStatus" /> <min value="1" /> <binding> <strength value="required" /> <valueSetReference> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueReference> <reference value="http://nictiz.nl/fhir/ConceptMap/Condition-Clinical-Status-Codes-to-ProbleemStatusCodelijst" /> <display value="Condition-Clinical-Status-Codes-to-ProbleemStatusCodelijst" /> </valueReference> </extension> <reference value="http://hl7.org/fhir/ValueSet/condition-clinical" /> </valueSetReference> </binding> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes) is available that maps ProblemStatusCodelist to the condition-clinical valueset." /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes) is available that maps ProblemStatusCodelist to the condition-clinical valueset." /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes) is available that maps ProblemStatusCodelist to the condition-clinical valueset." /> </mapping> </element> <element id="Condition.clinicalStatus.extension"> <path value="Condition.clinicalStatus.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Condition.clinicalStatus.extension:ProblemStatusCodelist"> <path value="Condition.clinicalStatus.extension" /> <sliceName value="ProblemStatusCodelist" /> <short value="clinicalstatus" /> <definition value="Describes the condition of the problem, use this extension to include the original ZIB code" /> <alias value="Probleemstatus" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/code-specification" /> </type> </element> <element id="Condition.clinicalStatus.extension:ProblemStatusCodelist.valueCodeableConcept:valueCodeableConcept"> <path value="Condition.clinicalStatus.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <binding> <strength value="extensible" /> <description value="ProbleemStatusCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.2--20171231000000" /> <display value="ProbleemStatusCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.4" /> <comment value="ProblemStatus. The relationship between the HCIM codes and the Resource codes is covered in the ConceptMaps: ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes and Condition-Clinical-Status-Codes-to-ProbleemStatusCodelijst" /> </mapping> </element> <element id="Condition.verificationStatus"> <path value="Condition.verificationStatus" /> <short value="VerificationStatus" /> <definition value="Clinical status of the problem or the diagnosis." /> <alias value="VerificatieStatus" /> <binding> <strength value="required" /> <valueSetReference> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueReference> <reference value="http://nictiz.nl/fhir/ConceptMap/VerificatieStatusCodelijst-to-ConditionVerificationStatus" /> <display value="VerificatieStatusCodelijst-to-ConditionVerificationStatus" /> </valueReference> </extension> <reference value="http://hl7.org/fhir/ValueSet/condition-ver-status" /> </valueSetReference> </binding> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.10" /> <comment value="VerificationStatus. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/VerificatieStatusCodelijst-to-ConditionVerificationStatus) is available." /> </mapping> </element> <element id="Condition.verificationStatus.extension"> <path value="Condition.verificationStatus.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Condition.verificationStatus.extension:VerificatieStatusCodelijst"> <path value="Condition.verificationStatus.extension" /> <sliceName value="VerificatieStatusCodelijst" /> <short value="Verificationstatus" /> <definition value="Describes the verification status of the problem, use this extension to include the original ZIB code" /> <alias value="VerificatieStatusCodelijst" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/code-specification" /> </type> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.10" /> <comment value="A ConceptMap (http://nictiz.nl/fhir/ConceptMap/VerificatieStatusCodelijst-to-ConditionVerificationStatus) is available" /> </mapping> </element> <element id="Condition.verificationStatus.extension:VerificatieStatusCodelijst.valueCodeableConcept:valueCodeableConcept"> <path value="Condition.verificationStatus.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <binding> <strength value="extensible" /> <description value="VerificatieStatusCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.4--20171231000000" /> <display value="VerificatieStatusCodelijst" /> </valueSetReference> </binding> </element> <element id="Condition.category"> <path value="Condition.category" /> <short value="ProblemType" /> <definition value="The type of problem; see the profile description." /> <alias value="ProbleemType" /> <binding> <strength value="extensible" /> <description value="The type of problem." /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.1--20171231000000" /> <display value="ProbleemTypeCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.8" /> <comment value="ProblemType" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.8" /> <comment value="ProblemType" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.8" /> <comment value="ProblemType" /> </mapping> </element> <element id="Condition.code"> <path value="Condition.code" /> <short value="ProblemName" /> <definition value="The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems." /> <alias value="ProbleemNaam" /> <min value="1" /> <binding> <strength value="extensible" /> <description value="The problem name defines the problem." /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.3--20171231000000" /> <display value="ProbleemNaamCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.3" /> <comment value="ProblemName" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.3" /> <comment value="ProblemName" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.3" /> <comment value="ProblemName" /> </mapping> </element> <element id="Condition.bodySite"> <path value="Condition.bodySite" /> <short value="ProblemAnatomicalLocation" /> <definition value="Anatomical location which is the focus of the procedure." /> <alias value="ProbleemAnatomischeLocatie" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodySite" /> </extension> <strength value="extensible" /> <description value="ProbleemAnatomischeLocatieCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.5--20171231000000" /> <display value="ProbleemAnatomischeLocatieCodelijst" /> </valueSetReference> </binding> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.11" /> <comment value="ProblemAnatomicalLocation" /> </mapping> </element> <element id="Condition.bodySite.extension"> <path value="Condition.bodySite.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Condition.bodySite.extension:Laterality"> <path value="Condition.bodySite.extension" /> <sliceName value="Laterality" /> <short value="ProblemLaterality" /> <definition value="Laterality adds information about body side to the anatomic location, e.g. left" /> <alias value="ProbleemLateraliteit" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier" /> </type> </element> <element id="Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept"> <path value="Condition.bodySite.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <binding> <strength value="extensible" /> <description value="ProblemLateralityCodelist" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.6--20171231000000" /> <display value="ProblemLateralityCodelist" /> </valueSetReference> </binding> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.12" /> <comment value="ProblemLaterality" /> </mapping> </element> <element id="Condition.subject"> <path value="Condition.subject" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.11" /> <comment value="Subject" /> </mapping> </element> <element id="Condition.context"> <path value="Condition.context" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Encounter" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-episodeofcare" /> </type> </element> <element id="Condition.onset[x]:onsetDateTime"> <path value="Condition.onsetDateTime" /> <sliceName value="onsetDateTime" /> <short value="ProblemStartDate" /> <definition value="Start of the disorder to which the problem applies. Especially in symptoms in which it takes longer for the final diagnosis, it is important to know not only the date of the diagnosis, but also how long the patient has had the disorder. A ‘vague’ date, such as only the year or the month and the year, is permitted." /> <alias value="ProbleemBeginDatum" /> <type> <code value="dateTime" /> </type> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.14" /> <comment value="DateTime" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.6" /> <comment value="ProblemStartDate" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.6" /> <comment value="ProblemStartDate" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.6" /> <comment value="ProblemStartDate" /> </mapping> </element> <element id="Condition.abatement[x]:abatementDateTime"> <path value="Condition.abatementDateTime" /> <sliceName value="abatementDateTime" /> <short value="ProblemEndDate" /> <definition value="Date on which the disorder to which the problem applies, is considered not to be present anymore. This date does not need to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted." /> <alias value="ProbleemEindDatum" /> <type> <code value="dateTime" /> </type> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.9" /> <comment value="ProblemEndDate" /> </mapping> </element> <element id="Condition.asserter"> <path value="Condition.asserter" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" /> </type> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.2" /> <comment value="InformationSource" /> </mapping> </element> <element id="Condition.asserter.extension"> <path value="Condition.asserter.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Condition.asserter.extension:practitionerRole"> <path value="Condition.asserter.extension" /> <sliceName value="practitionerRole" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" /> </type> </element> <element id="Condition.note"> <path value="Condition.note" /> <short value="Comment" /> <definition value="Comment by the one who determined or updated the Problem." /> <alias value="Toelichting" /> <mapping> <identity value="hcim-concernfortransfer-v1.2-2015EN" /> <map value="NL-CM:5.1.5" /> <comment value="Explanation" /> </mapping> <mapping> <identity value="hcim-concernfortransfer-v3.0-2016EN" /> <map value="NL-CM:5.1.5" /> <comment value="Explanation" /> </mapping> <mapping> <identity value="hcim-problem-v4.1-2017EN" /> <map value="NL-CM:5.1.5" /> <comment value="Comment" /> </mapping> </element> </differential> </StructureDefinition>